Paul Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62298 Issued in OR

Practice address

2005 Elm St Ste 200
Forest Grove, OR 97116-2781

Phone

(503) 357-9810

Fax

(503) 357-9819

NPI assigned

May 24, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prompt Physical Therapy Inc.Group PAC ID 4981675790, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Prompt Physical Therapy Inc.

  • Physical Therapist
  • Knoxville, TN
  • NPI 1245317783
  Medicare reassignment Care Compare group NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Forest Grove, OR
  • NPI 1477539765
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1578091344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 ELM ST STE 200",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162781",
            "telephone_number": "503-357-9810",
            "fax_number": "503-357-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PAUL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500725396",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "R195362",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "R194490",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonnie Irene White, LMT
• Marisa Jane Wickerath, MD
• Deborah Elaine Johnson Williams, O.D.
• Irene Mary Willison, RN
• Noah Wilson-Fey
• Rachael Leeann Wilson, PA-C
• Evan Wollen, O.D.
• Eva Wai-Man Wong
• King Cheong Brian Wong, DDS
• Eric Brian Woods, L.M.T.

• Physical Therapist in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.