Jerry D. Wilkerson, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1195120 Issued in TX

Practice address

6760 Old Jacksonville Hwy Ste 101
Tyler, TX 75703-0566

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1376616979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 SOUTHWOOD DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054132",
            "telephone_number": "337-477-9292",
            "fax_number": "337-477-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6760 OLD JACKSONVILLE HWY STE 101",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6760 Old Jacksonville Hwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757030566",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6760 Old Jacksonville Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757030572",
            "country_code": "US",
            "telephone_number": "337-263-2829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6760 Old Jacksonville Hwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757030566",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6760 Old Jacksonville Hwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757030566",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6760 Old Jacksonville Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757030572",
            "country_code": "US",
            "telephone_number": "337-263-2829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "JERRY",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1195120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Wild, CRNA
• Julie Wilder, OT
• Wiley Roosth MD & Associates
• Kodi Wiley
• Holly Wilhelm
• Matthew Harry Lee Wilkerson, M.D.
• Jessica Wilkin, M.D.
• Caitlin Nicole Wilkins, ATC, LAT
• Megan Wilkins, CCC-SLP
• Will J Parks DDS MD PA

• Physical Therapist in Tyler, TX
• Providers in Tyler, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.

Verify at the official NPI Registry.