Charles William Wilson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTH-006074 Issued in AZ

Practice address

5815 W. Utopia Rd.
Glendale, AZ 85308

Phone

(623) 806-7797

NPI assigned

Jan 13, 2023

Last updated

Jan 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Charlie William Wilson Other name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner - University Physician Specialists LLCGroup PAC ID 5991008054, 343 clinicians

Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Banner - University Physician Specialists LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1437529245
  Medicare reassignment Care Compare group NPD
• Midwestern University

  dba Midwestern University Multispecialty Clinic

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1932206414
  Medicare reassignment Care Compare group NPD
• Banner - University Physician Specialists LLC

  • Multi-Specialty Clinic/Center
  • Maricopa, AZ
  • NPI 1063887727
  NPD
• Banner - University Physician Specialists LLC

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1164255865
  NPD
• Midwestern University

  dba Midwestern University Eye Institute

  • Optometrist
  • Glendale, AZ
  • NPI 1891017745

  Occupational Therapist

  NPD
• Midwestern University

  dba Midwestern University Eye Institute-Downers Grove

  • Optometrist
  • Downers Grove, IL
  • NPI 1295126324
  NPD

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1811602865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 W LEWIS AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031071",
            "telephone_number": "602-570-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 W. UTOPIA RD.",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-806-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-006074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLIE",
            "last_name": "WILSON",
            "middle_name": "WILLIAM",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kathryn Leah Wilmot, RN
• Alysha Wilson
• Anthony Bradford Wilson
• Brian J Wilson, DDS
• Cassidy Wilson
• Daria Wilson, DPT
• Hannah Wilson, RBT
• Holly Wilson, P.T.
• Kristina Wilson, DMD
• Lori Anne Wilson, PSY.D., PSYCHOLOGIST

• Occupational Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.