Olivia Grace Wilson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

7931 Issued in MS

Practice address

1650 Lelia Dr
Jackson, MS 39216-4864

Phone

(601) 397-6390

Fax

(601) 510-2381

NPI assigned

Apr 30, 2025

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Beckwith Family Chiropractic, LLC

  • Chiropractor
  • Jackson, MS
  • NPI 1255731006
  NPD

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

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1922896661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LELIA DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164864",
            "telephone_number": "601-397-6390",
            "fax_number": "601-510-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LELIA DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164864",
            "telephone_number": "601-397-6390",
            "fax_number": "601-510-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "OLIVIA",
        "middle_name": "GRACE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-30",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "7931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Wilson, DC
• Kelly L Wilson
• Lucas Hillman Wilson
• Marianne Kerut Wilson, MD
• Mark E Wilson, MD
• Raegan Wilson, RN
• Roderick Wilson
• Shandra Wilson, LPC
• Shundra Wilson, FNP
• Travaughn Wilson

• Physical Therapy Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Physical Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.