Nicholas D Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-6515 Issued in OH

Practice address

476 Fortman Dr
Saint Marys, OH 45885-1870

Phone

(419) 300-8400

Fax

(419) 300-8401

NPI assigned

Oct 25, 2006

Sex

Male

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

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hometown Therapy Group LLCGroup PAC ID 2668731134, 3 clinicians

Practice addresses (Care Compare)

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.

• Hometown Therapy Group LLC

  • Physical Therapist
  • Ada, OH
  • NPI 1770094856
  Medicare reassignment Care Compare group NPD
• Superior Rehab, LLC

  • Physical Therapy Clinic/Center
  • Lima, OH
  • NPI 1114042116
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1437233103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "KALIDA",
            "state": "OH",
            "postal_code": "458530228",
            "telephone_number": "419-771-1073",
            "fax_number": "419-771-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 FORTMAN DR",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458851870",
            "telephone_number": "419-300-8400",
            "fax_number": "419-300-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NICHOLAS",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-6515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wheatland Dermatology LLC
• Dane B Widner, DDS
• Kimberly Wiener, NP-C
• Wilson Orthopedic and Sports PT
• Michelle Wilson, SLP
• Clarinda Yvette Wine
• Douglas J Wine, OD
• Jalyn Yvette Wine, STNA
• Susan Marie Wiseman, R.D., L.D.
• Wishing Well Clinic & Spa, LLC

• Physical Therapist in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.