Makenzi Wilson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

056439 Issued in NY

Practice address

364 Madison St
Waterville, NY 13480-1116

Phone

(315) 841-3222

Fax

(315) 841-4023

NPI assigned

Sep 14, 2026

Last updated

Sep 14, 2026By the provider in NPPES

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

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

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1952212698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST STE 100C",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121667",
            "telephone_number": "315-458-2552",
            "fax_number": "315-458-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 MADISON ST",
            "city": "WATERVILLE",
            "state": "NY",
            "postal_code": "134801116",
            "telephone_number": "315-841-3222",
            "fax_number": "315-841-4023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "792 N Main St Ste 100C",
            "address_purpose": "LOCATION",
            "city": "North Syracuse",
            "state": "NY",
            "postal_code": "132121667",
            "country_code": "US",
            "telephone_number": "315-458-2552",
            "fax_number": "315-458-2575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "323 Route 5 West",
            "address_2": "Ste 5",
            "address_purpose": "LOCATION",
            "city": "Weedsport",
            "state": "NY",
            "postal_code": "131669306",
            "country_code": "US",
            "telephone_number": "315-689-7989",
            "fax_number": "315-303-6505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "113 Schuyler St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "NY",
            "postal_code": "130691600",
            "country_code": "US",
            "telephone_number": "315-593-8786",
            "fax_number": "315-595-4032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Seneca Tpke Ste 3",
            "address_purpose": "LOCATION",
            "city": "Canastota",
            "state": "NY",
            "postal_code": "130324632",
            "country_code": "US",
            "telephone_number": "315-697-8514",
            "fax_number": "315-697-8147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MAKENZI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "056439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waterville Area Volunteer Ambulance Corp Inc.
• Waterville Central School
• Cindy Wessling, LPN
• Lauren Williams, LCSW
• Heather L Willson, RN

• Physical Therapist in Waterville, NY
• Providers in Waterville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; 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.