Individual provider Active NPI

Catherine Elizabeth Wilson, LPTA

  • Physical Therapy Assistant
  • Salem, NH
National Provider Identifier
1326336595
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
618 Issued in CT
Practice address
2 Keewaydin Dr
Salem, NH 03079-2839
Phone
(800) 995-2673
Fax
(866) 420-1055
NPI assigned
Jul 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 618 CT Primary

Addresses

Primary practice location

2 Keewaydin Dr
Salem, NH 03079-2839

Mailing address

5001 Statesman Dr
Irving, TX 75063-2414
Phone (877) 282-5613

Other names 1

  • Carrie Wilson Other name

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

LicenseStateTypeSpecialty
618CTMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1326336595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 STATESMAN DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632414",
            "telephone_number": "877-282-5613",
            "fax_number": "877-508-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 KEEWAYDIN DR",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792839",
            "telephone_number": "800-995-2673",
            "fax_number": "866-420-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "WILSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.