Laura Wilson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12850 Issued in TN

Practice address

176 W University Pkwy Ste E
Jackson, TN 38305-1618

Phone

(731) 300-4950

Fax

(731) 300-4951

NPI assigned

Nov 4, 2021

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

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Tennessee, HSC, College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Aegis Group Practice LLC

  • Physical Therapist
  • Germantown, TN
  • NPI 1174308647
  Medicare reassignment Care Compare group NPD
• Patterson Physical Therapy LLC

  • Physical Medicine & Rehabilitation Physician
  • Jackson, TN
  • NPI 1770928533

  Physical Therapist

  Medicare reassignment NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Memphis, TN
  • NPI 1245016690
  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030
  NPD

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1760147789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 W UNIVERSITY PKWY STE E",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051618",
            "telephone_number": "731-300-4950",
            "fax_number": "731-300-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 W UNIVERSITY PKWY STE E",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051618",
            "telephone_number": "731-300-4950",
            "fax_number": "731-300-4951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 US Highway 45 W",
            "address_purpose": "LOCATION",
            "city": "Humboldt",
            "state": "TN",
            "postal_code": "383438503",
            "country_code": "US",
            "telephone_number": "731-784-7771",
            "fax_number": "731-300-4951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LAURA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth E Wilson, LCSW
• James M. Wilson, D.D.S.
• John Wilson
• Jonathan Wilson, MAED, ATC, LAT, CSCS
• Kristen L Wilson, LPC-MHSP (TEMP), NCC
• Salah Wilson, MSW
• Shirley Ann Wilson, CASE MANAGER
• Tina Wilson, M.D.
• Terry L Winbush, LDC
• Raven Winston

• Physical Therapist in Jackson, TN
• Providers in Jackson, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.