Tonya Wilson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

116424 Issued in MO

Practice address

15822 Clayton Rd
Ellisville, MO 63011-2212

Phone

(636) 220-1681

NPI assigned

Sep 22, 2015

Last updated

Sep 22, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Legacy Healthcare Services

  • Clinic/Center
  • Ellisville, MO
  • NPI 1699131573
  NPD (past)
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD (past)

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1790154581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 WESTRIDGE PARC LN",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630214207",
            "telephone_number": "636-236-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15822 CLAYTON RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112212",
            "telephone_number": "636-220-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TONYA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "311679605",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "116424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West County Spine & Joint Chiropractic Clinic, LLC (West County Spine & Joint)
• Westglen Family Physicians, LLC
• Westglen Family Physicians, LLC
• Westglen Physicians, LLC
• Bernard David Wilken, D.D.S.
• Cynthia Becquette Winton
• Cathleen H Wolff
• William C Woodcock, D.C.
• Phillip D Worrell, R.PH., J.D.
• Sharon K Worrell, R.PH.

• Physical Therapy Assistant in Ellisville, MO
• Providers in Ellisville, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.