KATIE LYNN WILSON (NPI# 1972980779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972980779 |
| Entity Type | Individual |
| Full Name | KATIE LYNN WILSON |
| Credential | PT, DPT |
| Practice Address |
100 E Ferguson St Ste 1204 Tyler TX 75702-5700 |
| Practice Telephone | 9035092040 |
| Mailing Telephone | 9035092040 |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2018-03-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
1232246 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1972980779 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 Wsw Loop 323, Tyler, TX 757019416 | 9035091313 | 9035091383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
| 1861727273 | Katie Lynn Wilson | Licensed Practical Nurse | 3216 Dewey Pl Sw, Canton, OH 44710-1614 | 2009-10-03 |
| 1578738308 | Katie Kimmel Wilson | Counselor | 122 E Poplar Ave, Coeur D Alene, ID 83814-3436 | 2008-04-23 |
| 1871708263 | Katie Maud Wilson | Registered Nurse | Miami Valley Hospital, One Wyoming St, Dayton, OH 45409 | 2007-05-11 |
| 1225185119 | Katie E Wilson | Psychiatry & Neurology | 763 S. New Ballas Road, Suite 110, St. Louis, MO 63141 | 2007-01-04 |
| 1083229298 | Katie Wilson | Behavior Technician | 1215 Hightower Trl Ste B120, Atlanta, GA 30350-6205 | 2020-09-14 |
| 1114487501 | Katie Dougherty Wilson | Social Worker | 4851 Independence St, Wheat Ridge, CO 80033 | 2019-03-21 |
| 1538661509 | Katie Wilson | Speech-Language Pathologist | 4231 Dolly Ridge Rd, Vestavia, AL 35243-5703 | 2018-03-06 |
| 1073031100 | Katie Wilson | Nurse Practitioner | 1900 E Main St, Danville, IL 61832-5100 | 2017-09-08 |
| 1710401237 | Katie Wilson | Occupational Therapy Assistant | 1573 Muller Pkwy, Gardnerville, NV 89410-7918 | 2017-07-26 |
| Street Address |
100 E FERGUSON ST STE 1204 |
| City | TYLER |
| State | TX |
| Zip Code | 75702-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457539066 | Katrina Deanne Hornsby | Occupational Therapist | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2008-02-06 |
| 1609378793 | Leah Rae Tomez | Speech-Language Pathologist | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2018-03-05 |
| 1033619648 | Renea Schott | Specialist/Technologist | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2018-02-20 |
| 1134659204 | Rebecca Jordy | Student in an Organized Health Care Education/Training Program | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2017-06-12 |
| 1346796117 | Ashley Nicole Mitchell | Specialist/Technologist | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2016-08-31 |
| 1134673460 | Cindy Sue Zavadil | Occupational Therapy Assistant | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2016-08-03 |
| 1760935191 | Kacee Millsap | Occupational Therapist | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2016-08-02 |
| 1871046490 | Melody Millsap | Occupational Therapy Assistant | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2016-07-31 |
| 1821463720 | Rebecca Brock Hunt | Occupational Therapy Assistant | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2015-12-03 |
| 1760860860 | Megan Courtney Hanna | Occupational Therapy Assistant | 100 E Ferguson St Ste 1204, Tyler, TX 75702-5700 | 2015-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396173563 | Mary Flores | Physical Therapist | 3200 Troup Hwy Ste 120, Tyler, TX 75701-8364 | 2013-10-24 |
| 1649465444 | Kristi Killian Smith | Physical Therapist | 1001 W Sw Loop 323, Tyler, TX 75701-9416 | 2007-09-14 |
| 1730644105 | Glynna Tarrant Mcguffey | Physical Therapist | 921 Shiloh Rd Ste C120, Tyler, TX 75703-1407 | 2019-02-09 |
| 1396143327 | Paul Molina | Physical Therapist | 100 E Ferguson St, Suite 1204, Tyler, TX 75702-5759 | 2014-12-08 |
| 1760808612 | Lisa Chance | Physical Therapist | 100 E Ferguson St, Suite 1204, Tyler, TX 75702-5759 | 2014-03-14 |
| 1710324025 | Pediatric Therapeas Pllc | Physical Therapist | 4801 Troup Hwy Ste 800, Tyler, TX 75703-2357 | 2013-05-28 |
| 1750591012 | Thomas J Herman | Physical Therapist | 4801 Troup Hwy, Suite 800, Tyler, TX 75703-2356 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588271472 | Brain & Body Boost, LLC | Physical Therapist | 4360 Bristleleaf Ln, Prosper, TX 75078-1218 | 2020-09-25 |
| 1871108019 | Tu Khai Le | Physical Therapist | 13503 Parkstone View Cir, Houston, TX 77083-1820 | 2020-09-14 |
| 1518572171 | Kathryn Elizabeth Hill | Physical Therapist | 8603 Broadway St Ste 170, Pearland, TX 77584-8171 | 2020-09-10 |
| 1730797838 | Sara Burris | Physical Therapist | 2424 Wilcrest Dr Ste 109, Houston, TX 77042-2761 | 2020-07-15 |
| 1043838204 | Tiffany Ainsworth | Physical Therapist | 5454 Newcastle St Apt 232, Houston, TX 77081-2259 | 2020-07-13 |
| 1811510597 | Amanda Medina Calimbas | Physical Therapist | 1019 Warm Summer Dr, Richmond, TX 77406-2732 | 2020-05-28 |
| 1720600513 | Ll Pediatric Therapy LLC | Physical Therapist | 11200 Lakeline Mall Dr Ste Do5a, Cedar Park, TX 78613-1501 | 2020-05-14 |
| 1922620822 | Toddler Town Rehab, LLC | Physical Therapist | 5219 S Mccoll Rd Ste D, Edinburg, TX 78539-3168 | 2020-05-13 |
| 1083240790 | Assiduous Healthcare Group, LLC | Physical Therapist | 1300 Lowe Rd Unit 1301, Mansfield, TX 76063-8725 | 2020-03-14 |
| 1245865823 | Brandon Krinock | Physical Therapist | 12349 Metric Blvd Apt 1125, Austin, TX 78758-2537 | 2020-03-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.