Active NPI
Virginia Wilson Duke, PT
- Physical Therapist
- Vicksburg, MS
National Provider Identifier
1205210689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT5771
- Practice address
- 1901A Mission 66
Vicksburg, MS 39180-3711 - Phone
- (601) 634-4076
- Fax
- (601) 883-2232
- NPI assigned
- Jul 15, 2015
- 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 | PT5771 | MS | Primary |
Addresses
Primary practice location
1901A Mission 66
Vicksburg, MS 39180-3711
Mailing address
1901A Mission 66
Vicksburg, MS 39180-3711
Phone (601) 634-4076
Other names 1
- Virginia Wilson
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT5771 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473292800000",
"number": "1205210689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901A MISSION 66",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "391803711",
"telephone_number": "601-634-4076",
"fax_number": "601-883-2232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901A MISSION 66",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "391803711",
"telephone_number": "601-634-4076",
"fax_number": "601-883-2232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUKE",
"first_name": "VIRGINIA",
"middle_name": "WILSON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-15",
"last_updated": "2016-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT5771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "VIRGINIA",
"last_name": "WILSON",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Vicksburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.