Active NPI
Chandra C Wilson, PT
- Physical Therapist
- Pell City, AL
National Provider Identifier
1629134671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH3513
- Practice address
- 3319 Dr John Haynes Dr Ste 4
Pell City, AL 35125-1583 - Phone
- (205) 338-8440
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 | PTH3513 | AL | Primary |
Addresses
Primary practice location
3319 Dr John Haynes Dr Ste 4
Pell City, AL 35125-1583
Mailing address
1013 Baron LN
Chelsea, AL 35043-6628
Phone (205) 678-4849
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 |
|---|---|---|---|
| PTH3513 | AL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-South Home Health, LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629134671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 BARON LN",
"city": "CHELSEA",
"state": "AL",
"postal_code": "350436628",
"telephone_number": "205-678-4849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3319 DR JOHN HAYNES DR STE 4",
"city": "PELL CITY",
"state": "AL",
"postal_code": "351251583",
"telephone_number": "205-338-8440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CHANDRA",
"middle_name": "C",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH3513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pell City, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.