Active NPI
Sean D Wilson, PT
- Physical Therapist
- Tulsa, OK
National Provider Identifier
1437170834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2789
- Practice address
- 2424 E 21St St
Ste 400
Tulsa, OK 74114-1711 - Phone
- (918) 743-9235
- Fax
- (918) 743-9234
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2789 | OK | Primary |
Addresses
Primary practice location
2424 E 21St St
Ste 400
Tulsa, OK 74114-1711
Mailing address
2232 W Houston St
Broken Arrow, OK 74012-3529
Phone (918) 259-9522
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 |
|---|---|---|---|
| 2789 | OK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437170834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2232 W HOUSTON ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740123529",
"telephone_number": "918-259-9522",
"fax_number": "918-259-9521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 E 21ST ST",
"address_2": "STE 400",
"city": "TULSA",
"state": "OK",
"postal_code": "741141711",
"telephone_number": "918-743-9235",
"fax_number": "918-743-9234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SEAN",
"middle_name": "D",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "2789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.