Individual provider Active NPI

Brendan Charles Wilson, MPT

  • Physical Therapist
  • East Wenatchee, WA
National Provider Identifier
1649601907
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40885 Issued in CA
Practice address
230 Grant Rd Ste B27
East Wenatchee, WA 98802-7715
Phone
(509) 884-1437
Fax
(509) 884-2811
NPI assigned
Dec 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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 PT40885 CA Primary

Addresses

Primary practice location

230 Grant Rd Ste B27
East Wenatchee, WA 98802-7715

Mailing address

4930 W Kaweah CT
203
Visalia, CA 93277-8324
Phone (559) 713-6806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141014001796 WA Practitioner - Physical Therapist in Private Practice 0547490336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Physical Therapy PLLCGroup PAC ID 6305733858, 6 clinicians

Practice addresses (Care Compare)

230 Grant Rd
Suite B27
E Wenatchee, WA 98802-7715
Phone (509) 884-1437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT40885CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Physical Therapy, PLLC Physical Therapist CurrentSince May 22, 2023 Accepting new patients
Biomechanical Sports Therapy, Inc Physical Therapist CurrentSince Aug 11, 2014 Accepting new patients
Precision Rehabilitation & Orthopedic Physical Therapy Past Accepting new patients

Locations

230 Grant Rd
Ste B27
Wenatchee, WA 98802
Phone (509) 662-2575

18 N Worthen St
Ste 200
Wenatchee, WA 98801
Phone (509) 665-3156

Organizations & group practices 3

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": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1649601907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 W KAWEAH CT",
            "address_2": "203",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932778324",
            "telephone_number": "559-713-6806",
            "fax_number": "559-713-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 GRANT RD STE B27",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988027715",
            "telephone_number": "509-884-1437",
            "fax_number": "509-884-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRENDAN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-11",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT40885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.