Frederick Charles Wilson, PT ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

00156 Issued in MO

Practice address

18905 E 33Rd Street CT S
Independence, MO 64057-3336

Phone

(816) 589-0100

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Abbamark Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Independence, MO
  • NPI 1063481711

  Physical Therapist

  NPD (past) Authorized official
• Advanced Physical Therapy and Sports Rehabilitation, PA

  • Physical Therapy Clinic/Center
  • Overland Park, KS
  • NPI 1811941479

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558330886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18905 E 33RD STREET CT S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640573336",
            "telephone_number": "816-795-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18905 E 33RD STREET CT S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640573336",
            "telephone_number": "816-589-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "FREDERICK",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PT    ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "107962",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "00156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Lucille Williamson
• Jacquelyn Willig, LMT
• Karla D Wilmot, RNC,WHNP,MSN
• Benjamin Wilson, DDS
• Christina Wilson
• Greg Stephen Wilson, L.C.S.W.
• Heather C Wilson, LPC
• Kevin Poul Wilson, LPC
• Tanya Wilson
• Taylor Windsor

• Athletic Trainer in Independence, MO
• Providers in Independence, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.