Active NPI
Steven James Wilson, PHYSICAL THERAPIST
- Specialist
- Eureka, CA
National Provider Identifier
1134159197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PT7853
- Practice address
- 2306 Dean St
Eureka, CA 95501-3209 - Phone
- (707) 443-8354
- Fax
- (707) 443-8628
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PT7853 | CA | Primary |
Addresses
Primary practice location
2306 Dean St
Eureka, CA 95501-3209
Mailing address
2306 Dean St
Eureka, CA 95501-3209
Phone (707) 443-8354
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 650025835 | Other | CA | RR MEDICARE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT7853 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382659200000",
"number": "1134159197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2306 DEAN ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013209",
"telephone_number": "707-443-8354",
"fax_number": "707-443-8628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2306 DEAN ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013209",
"telephone_number": "707-443-8354",
"fax_number": "707-443-8628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STEVEN",
"middle_name": "JAMES",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2013-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "PT7853",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE #",
"identifier": "650025835",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.