Individual provider Active NPI

Misti Arlane Wilson, P.T.A.

  • Physical Therapy Assistant
  • Fort Smith, AR
National Provider Identifier
1508100553
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2577 Issued in AR
Practice address
2801 Old Greenwood Rd Ste 14
Fort Smith, AR 72903-4560
Phone
(479) 222-1425
NPI assigned
Nov 15, 2012
Last updated
May 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2577 AR Primary

Addresses

Primary practice location

2801 Old Greenwood Rd Ste 14
Fort Smith, AR 72903-4560

Mailing address

3819 Ridgemont Est
Mulberry, AR 72947-9174
Phone (479) 414-2810

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2577ARMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Little Angels Therapy and Women's Wellness Center, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1508100553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 RIDGEMONT EST",
            "city": "MULBERRY",
            "state": "AR",
            "postal_code": "729479174",
            "telephone_number": "479-414-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 OLD GREENWOOD RD STE 14",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034560",
            "telephone_number": "479-222-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MISTI",
        "middle_name": "ARLANE",
        "credential": "P.T.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "2577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.