Samuel Darious Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2571 Issued in AR

Practice address

910 Highway 62 65 N
Harrison, AR 72601-2148

Phone

(870) 704-4072

Fax

(870) 743-9881

NPI assigned

Apr 9, 2008

Last updated

Apr 11, 2024By the provider in NPPES

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

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrity Health Center, PLLCGroup PAC ID 6507953999, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrity Health Center, PLLC

  • Chiropractor
  • Harrison, AR
  • NPI 1831395565

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Mount Carmel Physical Therapy Center, PLLC

  • Physical Therapist
  • Harrison, AR
  • NPI 1912339771
  Medicare reassignment NPD

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1437322609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 N MAIN ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012214",
            "telephone_number": "870-741-4500",
            "fax_number": "870-741-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 HIGHWAY 62 65 N",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012148",
            "telephone_number": "870-704-4072",
            "fax_number": "870-743-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SAMUEL",
        "middle_name": "DARIOUS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Willmott, PHARMD
• Willow Street Health Center, LTD
• Amber Wilson
• Rebecca Monique Wilson
• Sadi Lou Wilson
• Amanda Jane Winford, FNP-C
• Wof, PLLC (Agape Health)
• Elizabeth Wolfe, LMSW
• Sabre Ayers Wright, OD
• Douglas Yeager, QBHP

• Physical Therapist in Harrison, AR
• Providers in Harrison, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.