Active NPI
Jonathan B Wilson, DO, DPT
- Student in an Organized Health Care Education/Training Program
- Birmingham, AL
National Provider Identifier
1811363575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 625 19TH St S
Birmingham, AL 35233-1900 - Phone
- (205) 934-6957
- NPI assigned
- Aug 18, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH7703 | AL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
625 19TH St S
Birmingham, AL 35233-1900
Mailing address
625 19TH St S
Birmingham, AL 35233-1900
Phone (205) 934-6957
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 511-68556 | Other | AL | BCBS OF AL |
| 511-68569 | Other | AL | BCBS OF AL |
| P01586197 | Other | AL | MEDICARE RR |
| 13765704 | Other | AL | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250725002825 | AL | Order and Referring Only - Physical Medicine and Rehabilitation | 7214245620 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH7703 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746316800000",
"number": "1811363575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 19TH ST S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352331900",
"telephone_number": "205-934-6957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 19TH ST S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352331900",
"telephone_number": "205-934-6957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JONATHAN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DO, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-18",
"last_updated": "2025-05-04",
"certification_date": "2025-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH7703",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "511-68556",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "511-68569",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P01586197",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13765704",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.