Justin Alan Wilson, OPA-C

Primary specialty

Orthopedic AssistantTaxonomy code 246ZX2200X

License

913

Practice address

16020 Park Valley Dr
Round Rock, TX 78681-3573

Phone

(512) 477-6341

Fax

(512) 477-1959

NPI assigned

Apr 20, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1285021071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7208 HARDY DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787572207",
            "telephone_number": "512-656-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16020 PARK VALLEY DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786813573",
            "telephone_number": "512-477-6341",
            "fax_number": "512-477-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JUSTIN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "OPA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": "913",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": "913",
            "primary": false
        },
        {
            "code": "246ZX2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Orthopedic Assistant",
            "state": null,
            "license": "913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHOPEDIC PHYSICIAN ASSISTANTS",
            "identifier": "#913",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert P. Wills, M.D.
• Luis Wilmot Jr., PA
• Sara Wilmot
• Emily A Wilson, OTR CLT
• Erica Michelle Wilson
• Kristie L Wilson, RN, MSN, CPNP
• Mackinzie Mae Wilson, CFY-SLP
• Steve C. Wilson, M.D.
• Travis J Wilson, M.D.
• Trinity Moreno Wilson, PTA

• Other Specialist/Technologist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Other Specialist/Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.