NPIMap

Individual provider Active NPI

Emily Wahl, PT

  • Physical Therapist
  • Draper, UT
National Provider Identifier
1790497121
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7504 Issued in MS
Practice address
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone
(985) 722-6545
NPI assigned
Dec 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 09771R LA
Physical Therapist 225100000X PT-2252 WY
Physical Therapist 225100000X 12999 MN
Physical Therapist 225100000X 070027562 IL
Physical Therapist 225100000X PT7504 MS Primary
Physical Therapist 225100000X 304245 CA
Physical Therapist 225100000X 050617 NY
Physical Therapist 225100000X PT031377 PA

Addresses

Primary practice location

65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096

Mailing address

9 Pine Ridge Dr
Laurel, MS 39440-3708
Phone (985) 722-6545

Other names 1

  • Emily Dawson Former name

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

LicenseStateTypeSpecialty
050617NYMDDentist
304245CAMDPhysical Therapist
070027562ILMDPhysical Therapist
09771RLAMDPhysical Therapist
12999MNMDPhysical Therapist
PT7504MSMDPhysical Therapist
PT031377PAMDPhysical Therapist
PT-2252WYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1790497121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PINE RIDGE DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394403708",
            "telephone_number": "985-722-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 E WADSWORTH PARK DR STE 230",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208096",
            "telephone_number": "985-722-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "EMILY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-16",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09771R",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-2252",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12999",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070027562",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT7504",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304245",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050617",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT031377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "DAWSON",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.