Individual provider Active NPI

Kayla Destin Wilcox, PT, DPT

  • Physical Therapist
  • Pensacola, FL
National Provider Identifier
1578170213
Registry record updated Sep 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35717 Issued in FL
Practice address
9310 Fowler Ave
Pensacola, FL 32534-1852
Phone
(850) 430-0600
NPI assigned
Sep 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 298389 CA
Physical Therapist 225100000X PT35717 FL Primary

Addresses

Primary practice location

9310 Fowler Ave
Pensacola, FL 32534-1852

Mailing address

9310 Fowler Ave
Pensacola, FL 32534-1852
Phone (850) 430-0600

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
298389CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1601164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601164800000",
    "number": "1578170213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9310 FOWLER AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325341852",
            "telephone_number": "850-430-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9310 FOWLER AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325341852",
            "telephone_number": "850-430-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "KAYLA",
        "middle_name": "DESTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-27",
        "last_updated": "2020-09-27",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298389",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2020; 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.