Stephen Bruce Wilmot, PT009355

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT009355 Issued in CA

Practice address

5740 Windmill Way
Suite 15
Carmichael, CA 95608-1379

Phone

(916) 482-7698

Fax

(916) 482-7798

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558416107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 MURRAY PL",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282510",
            "telephone_number": "916-967-2308",
            "fax_number": "916-482-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 WINDMILL WAY",
            "address_2": "SUITE 15",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956081379",
            "telephone_number": "916-482-7698",
            "fax_number": "916-482-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMOT",
        "first_name": "STEPHEN",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "PT009355",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT009355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.