Active NPI
Angela T. Wilson, PT
- Physical Therapist
- Excelsior Springs, MO
National Provider Identifier
1962629998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2009027345
- Practice address
- 1010 N Jesse James Rd
Excelsior Springs, MO 64024-1202 - Phone
- (620) 340-5085
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-02529 | KS | |
| Physical Therapist | 225100000X | 2009027345 | MO | Primary |
Addresses
Primary practice location
1010 N Jesse James Rd
Excelsior Springs, MO 64024-1202
Mailing address
1010 N Jesse James Rd
Excelsior Springs, MO 64024-1202
Phone (620) 340-5085
Other practice location 1
21003 NE 170th St
Kearney, MO 64060-9363
Phone (620) 340-5085
Other names 1
- Miss Angela T. Martin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2529 | KS | MD | Marriage & Family Therapist |
| 11-02529 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Key Rehabilitation, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659657600000",
"number": "1962629998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 N JESSE JAMES RD",
"city": "EXCELSIOR SPRINGS",
"state": "MO",
"postal_code": "640241202",
"telephone_number": "620-340-5085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 N JESSE JAMES RD",
"city": "EXCELSIOR SPRINGS",
"state": "MO",
"postal_code": "640241202",
"telephone_number": "620-340-5085"
}
],
"practiceLocations": [
{
"address_1": "21003 NE 170th St",
"address_purpose": "LOCATION",
"city": "Kearney",
"state": "MO",
"postal_code": "640609363",
"country_code": "US",
"telephone_number": "620-340-5085",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "ANGELA",
"middle_name": "T.",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2022-08-05",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-02529",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2009027345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "MARTIN",
"middle_name": "T.",
"prefix": "MISS",
"credential": "CPTA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Excelsior Springs, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.