Active NPI
Amy Ann Wilson, PT
- Physical Therapist
- Longview, TX
National Provider Identifier
1174707798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1178368
- Practice address
- 3201 4TH St
Longview, TX 75605-5145 - Phone
- (903) 236-4291
- NPI assigned
- Dec 18, 2007
- Last updated
- Dec 21, 2016
- 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 | 1178368 | TX | Primary |
Addresses
Primary practice location
3201 4TH St
Longview, TX 75605-5145
Mailing address
PO Box 838
Harleton, TX 75651-0838
Phone (903) 387-0451
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": "1197936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482278400000",
"number": "1174707798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 838",
"city": "HARLETON",
"state": "TX",
"postal_code": "756510838",
"telephone_number": "903-387-0451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 4TH ST",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756055145",
"telephone_number": "903-236-4291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "AMY",
"middle_name": "ANN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-18",
"last_updated": "2016-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1178368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.