Active NPI
Shannon Nicole Wilcox, PT
- Physical Therapist
- Olympia, WA
National Provider Identifier
1598996118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60099667
- Practice address
- 2108 Caton Way SW
Olympia, WA 98502-1105 - Phone
- (360) 352-1126
- NPI assigned
- Jul 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60099667 | WA | Primary |
Addresses
Primary practice location
2108 Caton Way SW
Olympia, WA 98502-1105
Mailing address
18504 Bothell Way NE
Bothell, WA 98011-1927
Phone (425) 481-1933
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT60099667 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1598996118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18504 BOTHELL WAY NE",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980111927",
"telephone_number": "425-481-1933",
"fax_number": "425-481-9371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2108 CATON WAY SW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985021105",
"telephone_number": "360-352-1126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "SHANNON",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-30",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60099667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.