Shannon Wilson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

048269 Issued in NY

Practice address

750 Hicksville Rd
Seaford, NY 11783-1328

Phone

(516) 520-6000

NPI assigned

Dec 2, 2021

Sex

Female

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

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evolving Gait Physical Therapy, P.C.

  • Physical Therapist
  • Medford, NY
  • NPI 1174165377
  Medicare reassignment NPD
• Island Sports Physiotherapy of East Meadow PC

  • Physical Therapy Clinic/Center
  • Garden City, NY
  • NPI 1356381669
  Medicare reassignment NPD
• Island Sports Physiotherapy of East Meadow, PC

  • Physical Therapy Clinic/Center
  • East Meadow, NY
  • NPI 1043265440
  NPD

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1386302792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 ROSEMONT ST",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117101120",
            "telephone_number": "516-375-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HICKSVILLE RD",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117831328",
            "telephone_number": "516-520-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra N Wilde, ATC
• Chris Wildenauer, D.C.
• Christine Wilhelm, LCSW
• Diana Elizabeth Williams
• Wilsco Distributors LLC
• Rena Winston, OTR/L
• Cristina Elizabeth Winters, M.S. CCC-SLP
• David Witkes, DO
• Jessica Wolfarth, LCSW
• Robin Wolpert, LCSW

• Physical Therapist in Seaford, NY
• Providers in Seaford, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.