Alyssa Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

02895 Issued in IA

Practice address

1228 Kirkwood Rd
Humeston, IA 50123-8041

Phone

(712) 520-0041

NPI assigned

Feb 27, 2023

Last updated

Feb 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Alyssa Clark Former name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Wilson Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Humeston, IA
  • NPI 1295434157

  Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1154020295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 KIRKWOOD RD",
            "city": "HUMESTON",
            "state": "IA",
            "postal_code": "501238041",
            "telephone_number": "712-520-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 KIRKWOOD RD",
            "city": "HUMESTON",
            "state": "IA",
            "postal_code": "501238041",
            "telephone_number": "712-520-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALYSSA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "CLARK",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lucas County Health Center (Humeston Medical Clinic)
• Mormon Trail C.S.D.
• Wayne County Hospital (Humeston Family Medical Clinic)
• Wilson Physical Therapy LLC

• Physical Therapist in Humeston, IA
• Providers in Humeston, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.