Leslie Diane Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5223 Issued in MS

Practice address

3451 Goodman Rd E Ste 108
Southaven, MS 38672-9305

Phone

(662) 890-6953

Fax

(662) 890-6954

NPI assigned

Jul 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Northeastern Ohio University College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland Orthopedic and Spine Institute, LLCGroup PAC ID 4880590413, 16 clinicians

Beacon Orthopaedics and Sports Medicine LTDGroup PAC ID 0345136412, 471 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.23 of 100Reported as group

Quality

59.13

Promoting interoperability

99

Improvement activities

40

Cost

75.81

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leslie.wilson.p1@direct.beaconortho.nextgenshare.com

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.

• Beacon Orthopaedics & Sports Medicine, LTD

  • Specialist
  • Cincinnati, OH
  • NPI 1386670065

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Cleveland Orthopedic and Spine Institute, LLC

  • Clinic/Center
  • Mayfield Heights, OH
  • NPI 1033988928
  Medicare reassignment Care Compare group NPD
• Ohio Luna Care Physical Therapy LLC

  • Physical Therapist
  • Columbus, OH
  • NPI 1285244996
  Medicare reassignment NPD
• Beacon Orthopaedics & Sports Medicine LTD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Worthington, OH
  • NPI 1699472878
  NPD

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1639424799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 600",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677286",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN RD E STE 108",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729305",
            "telephone_number": "662-890-6953",
            "fax_number": "662-890-6954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8066 Walnut Run Rd",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380188841",
            "country_code": "US",
            "telephone_number": "901-759-9210",
            "fax_number": "901-759-9138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45280 National Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Clairsville",
            "state": "OH",
            "postal_code": "439508787",
            "country_code": "US",
            "telephone_number": "740-247-7955",
            "fax_number": "614-304-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7277 Smiths Mill Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "OH",
            "postal_code": "430548195",
            "country_code": "US",
            "telephone_number": "614-304-2123",
            "fax_number": "614-304-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LESLIE",
        "middle_name": "DIANE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT017702",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT017702",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0317629",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Willis, PHARMD
• Antoinette Shane Wilson Banks, REGISTERED NURSE
• Brandye Nicole Wilson, P.A.
• Irene Wilson, FNP-C
• Jonathan William Wilson, O.D.
• Savannah Wilson, MS
• Shirley Ann Wilson, PHD
• Amanda L Wiltshire, AGNP-C
• Tarishan Winder
• Anna Windham, LCSW

• Physical Therapist in Southaven, MS
• Providers in Southaven, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.