Benjamin Dougles Wilson, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

06674 Issued in LA

Practice address

850 N Pierce St
Suite a
Lafayette, LA 70501-2848

Phone

(337) 261-9100

Fax

(337) 261-9700

NPI assigned

Jan 5, 2011

Sex

Male

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 LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Performance Physical Therapy Limited PartnershipGroup PAC ID 0446651178, 19 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peak Performance Physical Therapy Limited Partnership

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1770166886
  Medicare reassignment Care Compare group NPD
• Peak Performance Physical Therapy Limited Partnership

  • Durable Medical Equipment & Medical Supplies
  • Baton Rouge, LA
  • NPI 1376117069
  NPD
• Select Physical Therapy, LLC

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1053361840
  NPD (past)

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1932403003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11320 INDUSTRIPLEX BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708094108",
            "telephone_number": "225-663-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N PIERCE ST",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705012848",
            "telephone_number": "337-261-9100",
            "fax_number": "337-261-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BENJAMIN",
        "middle_name": "DOUGLES",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-05",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "06674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zadora Williams, MSW, LCSW
• Williford Wellness Counseling Services, LLC
• Aimee Williford, LPC
• Stacey Grace Willson, LCSW
• Ebony Wilridge
• Carly Wilson
• Chantell Wilson, CSW
• Coleman Mitchell Wilson, M.S., LPC
• Danielle Wilson
• J Patrick Wilson, MA LMFT LPC-S

• Physical Therapist in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.