Kacey Wilson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

2505 N Hwy 360 Ste 300
Grand Prairie, TX 75050-6494

Phone

(817) 861-7700

Fax

(844) 756-4608

NPI assigned

Jun 19, 2014

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Practice roles

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.

• Epic Pediatric Therapy, LP.

  • Rehabilitation Clinic/Center
  • Arlington, TX
  • NPI 1013163377
  NPD (past)

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1396159141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 ALMOND DR",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751262686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 N HWY 360 STE 300",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750506494",
            "telephone_number": "817-861-7700",
            "fax_number": "844-756-4608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3145 Denton Hwy",
            "address_purpose": "LOCATION",
            "city": "Haltom City",
            "state": "TX",
            "postal_code": "761173710",
            "country_code": "US",
            "telephone_number": "817-831-1078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KACEY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Octavia Williams, COTA
• Sylvia Williams, LPC
• Tamela Matrice Williams, RN
• Harold Willis
• April Dawn Wilson
• Wilve Home Healthcare , LLC
• Bethany Wimberly
• Jennifer Christine Winchester, MD
• Ashley Anthony Winters, LMSW
• Titilope Odunmorayo Witemire

• Physical Therapy Assistant in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.

Verify at the official NPI Registry.