Mary Lynn Wilson, P.T.

Individual provider Active NPI Physical Therapist · Middleburg, VA

NPI 1285709642 · NPPES record last updated Oct 14, 2010

Key facts

NPI
1285709642
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2305004796 (VA)
Practice address
204 E Federal St.
Suite C
Middleburg, VA 20117
Phone
(540) 687-6565
Fax
(540) 687-6585
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Del Wilson Physical Therapy Inc (4 clinicians)

Practice addresses (Care Compare)

204 E Federal St
Middleburg, VA 20117
Phone (540) 687-6565

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040102000326 VA Practitioner - Physical Therapist in Private Practice 1759287394 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Del Wilson Physical Therapy Inc Physical Therapist Current
since Jul 1, 2003
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305004796 VA Yes

Addresses

Primary practice location

204 E Federal St.
Suite C
Middleburg, VA 20117

Mailing address

PO Box 893
Middleburg, VA 20118-0893
Phone (540) 687-6565

Other providers in Middleburg, VA

All providers in Middleburg, VA · Physical Therapist in Virginia

Sources for this page

Verify at the official NPI Registry.