Jeanne Wilson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A6802 Issued in LA

Practice address

4451 Nelson Rd
Lake Charles, LA 70605-4136

Phone

(337) 564-5027

Fax

(337) 564-5028

NPI assigned

Dec 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Therapy Center of Jefferson Davis Parish, Inc

  • Physical Therapist
  • Jennings, LA
  • NPI 1508971045

  Physical Therapy Assistant

  NPD

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1750986816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705460849",
            "telephone_number": "337-824-8287",
            "fax_number": "337-824-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4451 NELSON RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054136",
            "telephone_number": "337-564-5027",
            "fax_number": "337-564-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JEANNE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "LA",
            "license": "A6802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin R. Wills, M.A., LPC, NCC
• Wilmark Anesthesia PLLC
• Delise Wilridge
• Michelle Wilridge
• Angel Wilson
• Kayla Renee Wilson, RLT
• Kiasia Wilson
• Madelin Wilson
• Paul Gregory Wilson II, LMHCA
• Dora Wiltz

• Physical Therapy Assistant in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Physical Therapy Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.