Andrew Michael Wilson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306603680 Issued in VA

Practice address

3585 Brambleton Ave
Roanoke, VA 24018-6521

Phone

(540) 776-1029

NPI assigned

Aug 7, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1144652595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 EDINBURGH DR NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240122110",
            "telephone_number": "540-354-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186521",
            "telephone_number": "540-776-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306603680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy R Willson, D.C.
• Tyler Davis Willson
• Claire Wilsey, PA
• Wilson Chiropractic Clinic
• Adrian Shawn Reid Wilson, PHARMD
• Autumn Simms Wilson, LPC
• Caitlin Ann Wilson, DO
• Cedric Wilson
• Christina Wilson, M.ED., CCC/SLP
• David Wilson, APRN

• Physical Therapy Assistant in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.