Elisabeth Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6306 Issued in OK

Practice address

500 E 141St St
Glenpool, OK 74033-3524

Phone

(812) 628-3060

Fax

(918) 322-3875

NPI assigned

May 30, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Redbud Physical Therapy LLCGroup PAC ID 4486939949, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Redbud Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Tulsa, OK
  • NPI 1710437306

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Redbud Physical Therapy LLC

  • Durable Medical Equipment & Medical Supplies
  • Skiatook, OK
  • NPI 1730831868
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1134812886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E 141ST ST",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740333524",
            "telephone_number": "918-322-3884",
            "fax_number": "918-322-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E 141ST ST",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740333524",
            "telephone_number": "812-628-3060",
            "fax_number": "918-322-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELISABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Whipple
• Emily White, DO
• William Scott White, D.D.S.
• Whitney Whittier, LCSW
• Williams Medical Group Practice, LLC
• Shaquinn D Wilson, LPN
• Jaycee Woodward
• Vanessa Lynn Zickefoose, APRN-CNP

• Physical Therapist in Glenpool, OK
• Providers in Glenpool, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.