Brian Todd Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL0016742 Issued in CO

Practice address

16542 Prospect LN
Broomfield, CO 80023-4606

Phone

(858) 752-8423

NPI assigned

Oct 17, 2006

Last updated

Jan 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Catalyst Physical Therapy & Wellness, Inc.

  • Physical Therapy Clinic/Center
  • San Diego, CA
  • NPI 1124456868

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Catalyst Physical Therapy and Wellness, Inc

  • Physical Therapist
  • Broomfield, CO
  • NPI 1023634763
  NPD Authorized official
• Rehab United Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • San Diego, CA
  • NPI 1134216294
  NPD (past)
• Rehab United Sports Medicine & Physical Therapy, Inc.

  • Customized Equipment (DME)
  • Escondido, CA
  • NPI 1891581971
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1699855981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 CAMINO DEL RIO S STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083520",
            "telephone_number": "619-501-2195",
            "fax_number": "619-501-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16542 PROSPECT LN",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800234606",
            "telephone_number": "858-752-8423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3959 Ruffin Rd",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231830",
            "country_code": "US",
            "telephone_number": "858-279-5570",
            "fax_number": "858-279-5303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1333 Camino Del Rio S Ste 103",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083520",
            "country_code": "US",
            "telephone_number": "619-501-2195",
            "fax_number": "619-501-2176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRIAN",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT33609",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 22916",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL0016742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxwell Schuller Williams, PA
• Staci Williams, CMT
• Susan Williams, MS, CCC-SLP
• Zachary Paul Williams
• Michelle Willix, LCSW
• Cindy Sue Wilson, DDS
• Dana Wilson, LMT
• Shannon Wilson, RDH
• Heidi McNutt Wingfield, MS
• Mariah Winter

• Physical Therapist in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.