Active NPI
Shannon Wilson
- Physical Therapy Assistant
- Knoxville, TN
National Provider Identifier
1841711173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2846
- Practice address
- 6102 Easton Rd
Knoxville, TN 37920-6434 - Phone
- (865) 599-6631
- Fax
- (865) 599-6631
- NPI assigned
- Jun 27, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | |||
| Physical Therapy Assistant | 225200000X | 2846 | TN | Primary |
Addresses
Primary practice location
6102 Easton Rd
Knoxville, TN 37920-6434
Mailing address
6102 Easton Rd
Knoxville, TN 37920-6434
Phone (865) 599-6631
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2846 | TN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550016000000",
"number": "1841711173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6102 EASTON RD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379206434",
"telephone_number": "865-599-6631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6102 EASTON RD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379206434",
"telephone_number": "865-599-6631",
"fax_number": "865-599-6631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SHANNON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-27",
"last_updated": "2019-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "2846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.