Active NPI
Christopher Ryan Wilson, MSPT
- Physical Therapist
- Augusta, GA
National Provider Identifier
1811175227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT009261
- Practice address
- 1355 Independence Dr
Augusta, GA 30901-1037 - Phone
- (706) 724-7746
- NPI assigned
- Feb 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 Therapist | 225100000X | PT009261 | GA | Primary |
Addresses
Primary practice location
1355 Independence Dr
Augusta, GA 30901-1037
Mailing address
460 Mall Blvd
Ste B
Savannah, GA 31406-4801
Phone (912) 644-5300
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT009261 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optim Orthopedics, LLC | Past | Accepting new patients | |
| Optim Orthopedics, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
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- Bluffton, SC
- NPI 1528451481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466035200000",
"number": "1811175227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "460 MALL BLVD",
"address_2": "STE B",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314064801",
"telephone_number": "912-644-5300",
"fax_number": "912-644-3369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1355 INDEPENDENCE DR",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309011037",
"telephone_number": "706-724-7746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CHRISTOPHER",
"middle_name": "RYAN",
"name_prefix": "Mr.",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-07",
"last_updated": "2016-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT009261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.