Glenda F Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 2610 Issued in FL

Practice address

2101 Northside Dr Unit 502
Panama City, FL 32405-3687

Phone

(850) 913-7040

Fax

(850) 913-0290

NPI assigned

Jul 25, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/0000070

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.

• Brain and Spine LLC

  • Neurology Physician
  • Panama City, FL
  • NPI 1942317896
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871516682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 NORTHSIDE DR",
            "address_2": "SUITE 502",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "32405",
            "telephone_number": "850-913-7040",
            "fax_number": "850-913-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NORTHSIDE DR UNIT 502",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053687",
            "telephone_number": "850-913-7040",
            "fax_number": "850-913-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GLENDA",
        "middle_name": "F",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 2610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y2361",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monte Revell Willis
• Terrie Willis, OT
• Willowdean D. Tiller, Inc.
• Cynthia Leigh Wilson, PSYD
• Felicia Loe Wilson, LMHC
• Jennifer N Wilson
• Joyce Dolce Wilson, CRNA
• Lauren Wilson
• Patricia H. Wilson, M.S., TVI/COMS, NBCT
• Richard Boulware Wilson, MD

• Physical Therapist in Panama City, FL
• Providers in Panama City, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.