Active NPI
Olivia Grace Wilkerson, DPT
- Physical Therapist
- Westfield, NJ
National Provider Identifier
1154091221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA02041900
- Practice address
- 1124 South Ave W
Westfield, NJ 07090-1419 - Phone
- (908) 233-1222
- Fax
- (908) 233-2021
- NPI assigned
- Sep 20, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA02041900 | NJ | Primary |
Addresses
Primary practice location
1124 South Ave W
Westfield, NJ 07090-1419
Mailing address
PO Box 1014
Clark, NJ 07066-1014
Phone (732) 855-9751
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 |
|---|---|---|---|
| 40QA02041900 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632096000000",
"number": "1154091221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1014",
"city": "CLARK",
"state": "NJ",
"postal_code": "070661014",
"telephone_number": "732-855-9751",
"fax_number": "732-855-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1124 SOUTH AVE W",
"city": "WESTFIELD",
"state": "NJ",
"postal_code": "070901419",
"telephone_number": "908-233-1222",
"fax_number": "908-233-2021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "OLIVIA",
"middle_name": "GRACE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-20",
"last_updated": "2021-09-20",
"certification_date": "2021-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA02041900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.