Active NPI
Wilson Pediatric Therapy LLC
- Clinical Social Worker
- Lexington, KY
National Provider Identifier
1356912612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- WILSON PEDIATRIC THERAPY LLC
- Practice address
- 424 Lewis Hargett Cir Ste B100
Lexington, KY 40503-3683 - Phone
- (859) 475-4305
- NPI assigned
- Jul 8, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kresta L Wilson
- Title
- Owner/Ceo
- Phone
- (859) 475-4305
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
424 Lewis Hargett Cir Ste B100
Lexington, KY 40503-3683
Mailing address
424 Lewis Hargett Cir Ste B100
Lexington, KY 40503-3683
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100751300 | Medicaid | KY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | wilsonpediatric.com |
National Provider Directory
National Provider Directory- Tax ID family
- Wilson Pediatric Therapy LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Early Intervention Provider Agency
- Lexington, KY
- NPI 1063734333
-
- Speech-Language Pathologist
- Lexington, KY
- NPI 1285977462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625702400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1627257600000",
"number": "1356912612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 LEWIS HARGETT CIR STE B100",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405033683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 LEWIS HARGETT CIR STE B100",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405033683",
"telephone_number": "859-475-4305"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILSON PEDIATRIC THERAPY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-07-08",
"last_updated": "2021-07-26",
"certification_date": "2021-07-26",
"status": "A",
"authorized_official_last_name": "WILSON",
"authorized_official_first_name": "KRESTA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "859-475-4305"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100751300",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "wilsonpediatric.com",
"affiliation": "N",
"endpointDescription": "website",
"address_1": "424 Lewis Hargett Cir Ste B100",
"city": "Lexington",
"state": "KY",
"country_code": "US",
"postal_code": "405033683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.