Active NPI
Jessica Leigh Wilkinson, PTA
- Physical Therapy Assistant
- West, TX
National Provider Identifier
1770066060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2124306
- Practice address
- 503 Meadow Dr
West, TX 76691-1018 - Phone
- (254) 826-5354
- NPI assigned
- Sep 12, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2124306 | TX | Primary |
Addresses
Primary practice location
503 Meadow Dr
West, TX 76691-1018
Mailing address
632 Erwin Rd
West, TX 76691-2407
Phone (304) 483-5261
Other names 1
- Jessica Leigh Samuels
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2124306 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536710400000",
"number": "1770066060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 ERWIN RD",
"city": "WEST",
"state": "TX",
"postal_code": "766912407",
"telephone_number": "304-483-5261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 MEADOW DR",
"city": "WEST",
"state": "TX",
"postal_code": "766911018",
"telephone_number": "254-826-5354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINSON",
"first_name": "JESSICA",
"middle_name": "LEIGH",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-12",
"last_updated": "2018-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2124306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "SAMUELS",
"middle_name": "LEIGH",
"credential": "PTA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in West, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.