Individual provider Active NPI

Christopher Nathan Wilson, PTA

  • Physical Therapy Assistant
  • Reno, NV
National Provider Identifier
1538649488
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A1147 Issued in NV
Practice address
9990 Double R Blvd Ste 200
Reno, NV 89521-4833
Phone
(775) 348-8800
NPI assigned
Aug 20, 2018
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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 A1147 NV Primary

Addresses

Primary practice location

9990 Double R Blvd Ste 200
Reno, NV 89521-4833

Mailing address

8000 Offenhauser Dr Apt 12a
Reno, NV 89511-1390
Phone (775) 336-7739

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
A1147NVMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1538649488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 OFFENHAUSER DR APT 12A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111390",
            "telephone_number": "775-336-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9990 DOUBLE R BLVD STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214833",
            "telephone_number": "775-348-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "NATHAN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A1147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.