Robert Dane Wilson, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017578 Issued in OH

Practice address

150 W Main St
New Albany, OH 43054-9229

Phone

(614) 685-9425

NPI assigned

Sep 24, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1972087195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W MAIN ST",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430549229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W MAIN ST",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430549229",
            "telephone_number": "614-685-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "middle_name": "DANE",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT017578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT017578",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sierra Ann-Marie White
• Robert D Whitehead, M.D.
• Mark Allen Willard, MD
• Kelly Williams, PT
• Kyanna Wilmer
• Bradley M Wolf, PA-C
• Dianna Womer
• Joel Christopher Wood, MD
• Teresa Wright
• Randall R. Wroble, MD

• Physical Therapist in New Albany, OH
• Providers in New Albany, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.