Active NPI
Kathryn Elaine Wilson
- Physical Therapist
- New Bern, NC
National Provider Identifier
1376199505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P21585
- Practice address
- 738 Newman Rd
New Bern, NC 28562-5238 - Phone
- (252) 633-6099
- Fax
- (252) 633-4047
- NPI assigned
- Aug 13, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05013519A | IN | |
| Physical Therapist | 225100000X | P21585 | NC | Primary |
Addresses
Primary practice location
738 Newman Rd
New Bern, NC 28562-5238
Mailing address
738 Newman Rd
New Bern, NC 28562-5238
Phone (252) 633-6099
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05013519A | IN | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661731200000",
"number": "1376199505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "738 NEWMAN RD",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285625238",
"telephone_number": "252-633-6099",
"fax_number": "252-633-4047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "738 NEWMAN RD",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285625238",
"telephone_number": "252-633-6099",
"fax_number": "252-633-4047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KATHRYN",
"middle_name": "ELAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-13",
"last_updated": "2022-08-29",
"certification_date": "2022-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05013519A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P21585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bern, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.