Caressa Corine Wilson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5379 Issued in AR

Practice address

1500 N Mississippi St
Little Rock, AR 72207-5851

Phone

(501) 217-8600

Fax

(501) 217-8636

NPI assigned

Oct 27, 2023

Sex

Female

Sole proprietor

No

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

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• MCT, Inc.

  • Speech-Language Pathologist
  • Little Rock, AR
  • NPI 1881738409

  Physical Therapist

  Medicare reassignment NPD
• MCT, Inc.

  • Developmental Disabilities Clinic/Center
  • Little Rock, AR
  • NPI 1881005387
  NPD

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1851163380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10618 BRECKENRIDGE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111802",
            "telephone_number": "501-217-8600",
            "fax_number": "501-217-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N MISSISSIPPI ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075851",
            "telephone_number": "501-217-8600",
            "fax_number": "501-217-8636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10618 Breckenridge Dr",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722111802",
            "country_code": "US",
            "telephone_number": "501-217-8600",
            "fax_number": "501-217-8636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CARESSA",
        "middle_name": "CORINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Wilson, CPNP-PC
• Aubrey Wilson
• Audra Anne Wilson, PA-C
• Barbara Jean Wilson, OTR
• Brett Lonnis Wilson, LPC
• Cherrelle L Wilson, MHPP
• Cheyenne Wilson
• Christine Wilson, MS, ATR, LPC
• Darius Wilson, MS
• David Keith Wilson II, DO

• Physical Therapist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.