NPIMap

Organization Active NPI

Wilson Physical Therapy

  • Physical Therapist
  • Fargo, ND
National Provider Identifier
1851591150
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
938 Issued in ND
Legal business name
WILSON PHYSICAL THERAPY
Practice address
3101 Broadway N
Suite C
Fargo, ND 58102-1485
Phone
(701) 526-3498
Fax
(701) 526-3818
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Authorized official

Name
Jay Wilson, DPTNPI 1104995604
Title
President
Phone
(701) 526-3498

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 938 ND Primary

Addresses

Primary practice location

3101 Broadway N
Suite C
Fargo, ND 58102-1485

Mailing address

3101 Broadway N
Suite C
Fargo, ND 58102-1485
Phone (701) 526-3498

National Provider Directory

National Provider Directory

Locations

3101 Broadway N
Ste C
Fargo, ND 58102
Phone (701) 271-1000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1851591150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BROADWAY N",
            "address_2": "SUITE C",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021485",
            "telephone_number": "701-526-3498",
            "fax_number": "701-526-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BROADWAY N",
            "address_2": "SUITE C",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021485",
            "telephone_number": "701-526-3498",
            "fax_number": "701-526-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-526-3498",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.