Active NPI
Kelli Wilkerson, PT
- Physical Therapist
- Salem, OH
National Provider Identifier
1255406641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 009590
- Practice address
- 2308 Southeast Blvd
Salem, OH 44460-3418 - Phone
- (330) 332-8488
- Fax
- (330) 332-4441
- NPI assigned
- Nov 21, 2006
- 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 | 009590 | OH | Primary |
Addresses
Primary practice location
2308 Southeast Blvd
Salem, OH 44460-3418
Mailing address
6802 S Olympia Ave
Ste 300
Tulsa, OK 74132-1826
Phone (918) 749-0762
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 |
|---|---|---|---|
| 3991 | OK | MD | Chiropractor |
| 009590 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1255406641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6802 S OLYMPIA AVE",
"address_2": "STE 300",
"city": "TULSA",
"state": "OK",
"postal_code": "741321826",
"telephone_number": "918-749-0762",
"fax_number": "918-744-4246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2308 SOUTHEAST BLVD",
"city": "SALEM",
"state": "OH",
"postal_code": "444603418",
"telephone_number": "330-332-8488",
"fax_number": "330-332-4441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "KELLI",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "009590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.