Johanna A Wilson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

60 Brimley Dr
Fredericksburg, VA 22406-5148

Phone

(540) 369-6458

NPI assigned

Sep 28, 2021

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1801567904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 FORBES ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224051419",
            "telephone_number": "703-973-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BRIMLEY DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224065148",
            "telephone_number": "540-369-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHANNA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Wilson
• Courtney R Wilson, SLP
• Emily L Wilson, OT
• Felicia Wilson
• Jennifer Leigh Wilson, F.N.P.
• Leon M Wilson, LPC
• Madeleine Avery Wilson, MD
• Madison S Wilson
• Sammy Wilson
• Shannon Leigh Wilson

• Physical Therapy Assistant in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.