Mary C. Wilson, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15035 Issued in MD

Practice address

1205 York Rd
19
Lutherville Timonium, MD 21093-6210

Phone

(410) 296-9195

Fax

(410) 296-9197

NPI assigned

Feb 22, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Groschan Physical Therapy Specialists LLCGroup PAC ID 4587025077, 6 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.

• Groschan Physical Therapy Specialists LLC

  • Physical Therapist
  • Timonium, MD
  • NPI 1417631680
  Medicare reassignment Care Compare group NPD
• Life Fitness Physical Therapy LLC

  • Physical Therapist
  • Ellicott City, MD
  • NPI 1285882670
  NPD (past)
• Wilson & Chizmar Physical Therapy Associates PA

  • Physical Therapist
  • Nottingham, MD
  • NPI 1396870283
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1760517585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "19",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-296-9195",
            "fax_number": "410-296-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "19",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-296-9195",
            "fax_number": "410-296-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARY",
        "middle_name": "C.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "15035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FEDERAL",
            "identifier": "S9550001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35184405",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA2862 P00046856",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Gabriella Wallick, LMHC
• Pamela C Watkins, LGPC
• Sarah Marie Weitzel, MS CCC-SLP
• Brandon Marshall West, DDS, MS
• Stephanie A Willard, LCPC
• Wolf Lactation, LLC
• Jennifer Wolf, RN, IBCLC
• York Rd Pharmacy (Lutherville Pharmacy)
• Melissa E Zim, PTA
• Lauren Zolluccio, LCSW-C

• Physical Therapist in Lutherville Timonium, MD
• Providers in Lutherville Timonium, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.