Elizabeth Wilson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5714 Issued in OK

Practice address

2603 S 15TH PL
Broken Arrow, OK 74012-7285

Phone

(918) 251-7199

Fax

(539) 777-2501

NPI assigned

Jan 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hyland Physical Therapy and Wellness LLCGroup PAC ID 7618200874, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Hyland Physical Therapy and Wellness, LLC

  • Physical Therapy Clinic/Center
  • Broken Arrow, OK
  • NPI 1033670492
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1215641493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1678",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740131678",
            "telephone_number": "918-251-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 S 15TH PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127285",
            "telephone_number": "918-251-7199",
            "fax_number": "539-777-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "5714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty L Williamson, COTA/L
• Kenneth Wills
• Jonathan Willson
• Bradley Rix Wilson, DDS, MSD
• Carly R Wilson, MS
• Joleen Wilson, RD/LD
• Katelyn Brooke Wilson, DPT
• Tarra Lynn Wilson, RBT
• Megan Rey Winford, APRN
• Louryse L. Winn

• Occupational Therapist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.