Active NPI
Brandon Nicholas Wilson, DPT
- Orthopedic Physical Therapist
- Richland, WA
National Provider Identifier
1659874246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT60761377
- Practice address
- 1351 Fowler St
Richland, WA 99352-4714 - Phone
- (509) 946-1654
- NPI assigned
- Mar 9, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT60761377 | WA | Primary |
Addresses
Primary practice location
1351 Fowler St
Richland, WA 99352-4714
Mailing address
3003 Queensgate Dr Apt 329
Richland, WA 99352-4237
Phone (919) 376-6908
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT60761377 | WA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1659874246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 QUEENSGATE DR APT 329",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524237",
"telephone_number": "919-376-6908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 FOWLER ST",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524714",
"telephone_number": "509-946-1654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BRANDON",
"middle_name": "NICHOLAS",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-09",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "WA",
"license": "PT60761377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.