Individual provider Active NPI

Anne Wilson

  • Physical Therapist
  • Peachtree City, GA
National Provider Identifier
1154771384
Registry record updated Jun 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012296 Issued in GA
Practice address
201 Crosstown Dr
Peachtree City, GA 30269-3454
Phone
(770) 769-2390
NPI assigned
Jun 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT012296 GA Primary

Addresses

Primary practice location

201 Crosstown Dr
Peachtree City, GA 30269-3454

Mailing address

201 Crosstown Dr
Peachtree City, GA 30269-3454
Phone (770) 769-2390

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

NPI Registry JSON

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

{
    "created_epoch": "1466294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466294400000",
    "number": "1154771384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CROSSTOWN DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693454",
            "telephone_number": "770-769-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CROSSTOWN DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693454",
            "telephone_number": "770-769-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-19",
        "last_updated": "2016-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2016; 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.