Individual provider Active NPI

Wiloise Harper, PTA

  • Physical Therapy Assistant
  • Savannah, GA
National Provider Identifier
1609306182
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA003563 Issued in GA
Practice address
1 Peachtree Dr
Savannah, GA 31419-1200
Phone
(800) 243-4556
Fax
(484) 813-6530
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA003563 GA Primary

Addresses

Primary practice location

1 Peachtree Dr
Savannah, GA 31419-1200

Mailing address

11910 White Bluff Rd Apt M7
Savannah, GA 31419-1534

Other names 1

  • Wiloise Jackson Former name

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

LicenseStateTypeSpecialty
PTA003563GAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1609306182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11910 WHITE BLUFF RD APT M7",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEACHTREE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191200",
            "telephone_number": "800-243-4556",
            "fax_number": "484-813-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "WILOISE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA003563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILOISE",
            "last_name": "JACKSON",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.