Katelyn Nicole Wilson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4048 Issued in SC

Practice address

460 William Hilton Pkwy Ste B
Hilton Head Island, SC 29926-2498

Phone

(843) 277-0270

NPI assigned

Aug 6, 2020

Last updated

Aug 6, 2020By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health Performance Systems LLC

  • Chiropractor
  • Bluffton, SC
  • NPI 1437647070
  NPD
• Hope Performance Systems LLC

  • Mental Health Counselor
  • Hilton Head Island, SC
  • NPI 1033607676
  NPD

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1457961187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BRINDLEWOOD DR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072665",
            "telephone_number": "717-576-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 WILLIAM HILTON PKWY STE B",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262498",
            "telephone_number": "843-277-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATELYN",
        "middle_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "4048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Whitehead
• Steven Wiersma, MD
• Patrick George Wiita, M.D.
• Brian Charles Wilhelm, DPT
• William I. Petty II, M.D., LLC
• Jennifer Winzeler, CHWC
• Douglas James Wolter, M.A.
• Women's Healthcare Associates, PA
• Gregory Wright, PA-C
• Your Personal Defibrillator Expert, LLC (Good To Be Alive)

• Physical Therapy Assistant in Hilton Head Island, SC
• Providers in Hilton Head Island, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.