Walter Brad Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1648 Issued in TN

Practice address

766 Highway 46 S
Dickson, TN 37055-2556

Phone

(615) 446-5121

Fax

(615) 446-1357

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Medical College of Georgia School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Clinton, TN
  • NPI 1376073262
  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462
  NPD
• Lawrenceburg Physical Therapy, LLC

  • Physical Therapist
  • Lawrenceburg, TN
  • NPI 1902964042
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1649255407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR",
            "address_2": "SUITE 209",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552855",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 HIGHWAY 46 S",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552556",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WALTER",
        "middle_name": "BRAD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "1648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "446647",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3144510",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camerone Williams
• Debra Renay Williams, LPN
• Jaret Williamson
• Michael S Willis, D.M.D.
• Scott Alan Wilson, MS
• William Storm Wilson, DPT
• Cathleen Wixon, M.A.
• Leslie Shepard Wolfe, PHARM.D.
• Womens Health Center of Dickson
• Angela Wood

• Physical Therapist in Dickson, TN
• Providers in Dickson, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.