Active NPI
Robert J Wilson, LMT
- Massage Therapist
- Lincoln City, OR
National Provider Identifier
1316503790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 16836
- Practice address
- 4783 SW Highway 101
Lincoln City, OR 97367-1564 - Phone
- (541) 994-1819
- NPI assigned
- May 11, 2019
- Last updated
- May 11, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 16836 | OR | Primary |
Addresses
Primary practice location
4783 SW Highway 101
Lincoln City, OR 97367-1564
Mailing address
4783 SW Highway 101
Lincoln City, OR 97367-1564
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 |
|---|---|---|---|
| 16836 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557532800000",
"number": "1316503790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4783 SW HIGHWAY 101",
"city": "LINCOLN CITY",
"state": "OR",
"postal_code": "973671564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4783 SW HIGHWAY 101",
"city": "LINCOLN CITY",
"state": "OR",
"postal_code": "973671564",
"telephone_number": "541-994-1819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-11",
"last_updated": "2019-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "16836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.