Philip Matthew Wilson, MS, RCEP, CCRP

Primary specialty

Clinical Exercise PhysiologistTaxonomy code 224Y00000X

License

1068726

Practice address

1717 North E Street
Tower 1, Suite 1
Pensacola, FL 32501

Phone

(850) 908-2235

NPI assigned

Dec 6, 2021

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

Credentials

Master of Science

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1144988395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 N E ST STE 103",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325016337",
            "telephone_number": "850-908-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 NORTH E STREET",
            "address_2": "TOWER 1, SUITE 1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32501",
            "telephone_number": "850-908-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PHILIP",
        "middle_name": "MATTHEW",
        "credential": "MS, RCEP, CCRP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-06",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": "1068726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli M Wilson
• Kelsey Lynne Wilson
• Leah Wilson, APRN
• Nancy Lee Wilson
• Patricia Alexander Wilson, MSN ARNP
• Quang Van Wilson, OD
• Rachel Lynn Wilson, MEDICAL ASSISTANT
• Robert Henry Wilson, PHARMACIST
• Robert K Wilson Jr., MD
• Sara Marie Wilson, CPNP-AC

• Clinical Exercise Physiologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinical Exercise Physiologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.