Individual provider Active NPI

Allison L Wilson, DPT

  • Physical Therapist
  • Bowling Green, KY
National Provider Identifier
1609074608
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005635 Issued in KY
Practice address
165 Natchez Trace
Suite 200
Bowling Green, KY 42103-7947
Phone
(270) 796-4698
Fax
(270) 782-3274
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 005635 KY Primary

Addresses

Primary practice location

165 Natchez Trace
Suite 200
Bowling Green, KY 42103-7947

Mailing address

201 Park Street
Bowling Green, KY 42101-1708
Phone (270) 796-4698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101102000643 KY Practitioner - Physical Therapist in Private Practice 2961696190 Reassigns benefits to 1 organization
I20130701000091 TN Practitioner - Physical Therapist in Private Practice 2961696190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Tennessee, HSC, College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

165 Natchez Trace Ave
Suite 200
Bowling Green, KY 42103-7947
Phone (270) 781-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005635KYMDPhysical Therapist
7847TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedics & Sports Medicine PLC Physical Therapist Current Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Sep 15, 2022 Accepting new patients
Premier Orthopaedics & Sports Medicine, PLC CurrentSince Jun 17, 2013 Accepting new patients
Premier Orthopaedics & Sports Medicine, PLC CurrentSince Jun 17, 2013 Accepting new patients
Graves Gilbert Clinic PLLC Physical Therapist CurrentSince Sep 15, 2022 Accepting new patients

Locations

165 Natchez Trace Ave
Ste 200
Bowling Green, KY 42103
Phone (270) 782-7800

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

1330 N Race St
Glasgow, KY 42141
Phone (270) 629-2780

394 Harding Pl
Ste 200
Nashville, TN 37211
Phone (615) 834-4482

Interoperability endpoints

  • Direct secure messaging: allison.wilson.1@321.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1609074608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK STREET",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011708",
            "telephone_number": "270-796-4698",
            "fax_number": "270-782-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 NATCHEZ TRACE",
            "address_2": "SUITE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037947",
            "telephone_number": "270-796-4698",
            "fax_number": "270-782-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALLISON",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.