Karen Rene Wilson, PA-C, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2777 Issued in AK

Practice address

9100 Centennial Cir
Anchorage, AK 99504-1480

Phone

(406) 531-5276

NPI assigned

Nov 14, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rejuvenate LLCGroup PAC ID 4486627155, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Rejuvenate LLC

  • Physical Therapy Clinic/Center
  • Seeley Lake, MT
  • NPI 1790889855

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Montana Neurobehavioral Specialists

  • Neurology Physician
  • Missoula, MT
  • NPI 1013961671
  NPD (past)
• Seeley Swan Pharmacy Inc

  • Community/Retail Pharmacy
  • Seeley Lake, MT
  • NPI 1134390172
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1679645683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 FIELDSTONE XING",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598028602",
            "telephone_number": "406-531-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 CENTENNIAL CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995041480",
            "telephone_number": "406-531-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAREN",
        "middle_name": "RENE",
        "credential": "PA-C, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "492",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "298",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "2777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679645683",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4302623",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Nadia Wilson
• Hilary Wilson
• Jessica Laneice Wilson, BHRN
• Johanna Wilson, RN
• Julie Lynn Wilson, M.D.
• Kelly Wilson
• Kirk B Wilson Jr., N.C.M.T.B.
• Lena Marie Wilson, LPN
• Lindsey Wilson
• Makayla Wilson

• Physical Therapist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.