J&L Wilson Enterprises LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

J&L WILSON ENTERPRISES LLC

Practice address

25465 Leffen LN
Joplin, MO 64801-6366

Phone

(417) 529-7693

NPI assigned

Oct 14, 2022

Organization subpart

No

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

Authorized official

Name

Jimmie Wilson, PT, DPTNPI 1053531939

Title

PT/Owner

Phone

(417) 529-7693

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jimmie Joe Wilson, PT

  • Physical Therapist
  • Joplin, MO
  • NPI 1053531939

  KS, MO, Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1346966017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25465 LEFFEN LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648016366",
            "telephone_number": "417-529-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25465 LEFFEN LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648016366",
            "telephone_number": "417-529-7693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J&L WILSON ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "417-529-7693",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.imovephysicaltherapy.com",
            "affiliation": "N",
            "address_1": "25465 Leffen Ln",
            "city": "Joplin",
            "state": "MO",
            "country_code": "US",
            "postal_code": "648016366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Addison Ipock, RBT
• Brian J. Ipsen, MD
• Ryan Lance Ireland, PHARM D
• John Harland Irlam, D.O.
• Isd Renal Inc
• Wasey Jabbar, MD
• Hafsa Jabeen
• Michael Jack, CRNA
• Jennifer Jacks, COTA/L
• Anastasia Jackson, CRNA

• All providers in Joplin, MO
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.