Organization Active NPI

Wilson Physical Therapy. P.a., Inc

  • Physical Therapy Clinic/Center
  • Stuart, FL
National Provider Identifier
1689892952
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
FLPT0006232 Issued in FL
Legal business name
WILSON PHYSICAL THERAPY. P.A., INC
Practice address
1989 S. Federal Highway
Suite 203
Stuart, FL 34994-3949
Phone
(772) 781-5681
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Mr. Dwight E WilsonNPI 1598867798
Title
Owner/Physiotherapist
Phone
(772) 781-5681

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X FLPT0006232 FL Primary

Addresses

Primary practice location

1989 S. Federal Highway
Suite 203
Stuart, FL 34994-3949

Mailing address

1989 S. Federal Highway
Suite 203
Stuart, FL 34994-3949
Phone (772) 781-5681

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128001071 FL Part B Supplier - Clinic/Group Practice 0840193728 Receives reassigned benefits from 1 practitioner
Practice locations: Stuart, FL

National Provider Directory

National Provider Directory

Locations

1989 SE Federal Hwy
Ste 202
Stuart, FL 34994
Phone (561) 746-1099

1989 SE Federal Hwy
Ste 203
Stuart, FL 34994
Phone (772) 781-5681

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1689892952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 S. FEDERAL HIGHWAY",
            "address_2": "SUITE 203",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943949",
            "telephone_number": "772-781-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 S. FEDERAL HIGHWAY",
            "address_2": "SUITE 203",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943949",
            "telephone_number": "772-781-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON PHYSICAL THERAPY. P.A., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PHYSIOTHERAPIST",
        "authorized_official_telephone_number": "772-781-5681",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "FLPT0006232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.