PHILLIP CURTIS WILKERSON (NPI# 1447760376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447760376 |
| Entity Type | Individual |
| Full Name | PHILLIP CURTIS WILKERSON |
| Other Name | N/A N/A N/A |
| Credential | ATC |
| Practice Address |
4251 Powhatan Ave Norfolk VA 23508-2225 |
| Mailing Address |
413 Lake Havasu Dr Virginia Beach VA 23454-3976 |
| Practice Telephone | 7576834255 |
| Mailing Telephone | 7573813280 |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2017-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
0126002836 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | STATE LICENSURE | 003741 | 01 |
| IL | STATE LICENSURE | 096.002700 | 01 |
| VA | STATE LICENSURE | 0126002836 | 01 |
| BOC CERTIFICATION | 120402189 | 01 | |
| AR | STATE LICENSURE | 408 | 01 |
| Street Address |
4251 POWHATAN AVE |
| City | NORFOLK |
| State | VA |
| Zip Code | 23508-2225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518366772 | Kimberly Vaughan | Specialist/Technologist | 4251 Powhatan Ave, Norfolk, VA 23508-2225 | 2014-08-13 |
| 1023465887 | Jonathan Hartman | Specialist/Technologist | 4251 Powhatan Ave, Norfolk, VA 23508-2225 | 2016-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902429152 | Madison Mcnicholas | Student in an Organized Health Care Education/Training Program | 5115 Hamptom Blvd, Norfolk, VA 23508 | 2020-05-22 |
| 1689173353 | Paraclete Therapeutic Solutions LLC | Community/Behavioral Health | 5215 Colley Ave Ste 107, Norfolk, VA 23508 | 2018-02-07 |
| 1104369305 | Melissa Joy Day | Physical Therapist | 1015 W 47th St., Norfolk, VA 23508 | 2016-11-21 |
| 1629323787 | Tara Dodson Olsson | Physical Therapist | 1015 West 47th Street, Norfolk, VA 23508 | 2012-07-16 |
| 1760776181 | Amelia Cady Dumond Dail | Behavioral Analyst | 810 52nd St, Norfolk, VA 23508 | 2011-06-02 |
| 1568789824 | Alternative Therapeutic Home Care Inc | Health Maintenance Organization | 427 W 37th Street, Norfolk, VA 23508 | 2010-04-27 |
| 1730402421 | Benjamin Simon Mccarty | Dentist | 1170 Lexan Ave Ste 187, Norfolk, VA 23508 | 2010-03-09 |
| 1174754063 | Dominion Medical Supplies | Durable Medical Equipment & Medical Supplies | 4110 Granby St, Norfolk, VA 23508 | 2009-07-27 |
| 1992767297 | Catherine Jean Mcdonald | Nurse Practitioner | 1618 Pocahontas Drive, Medical Readiness Division, Comnavsurflant, Norfolk, VA 23508 | 2006-04-04 |
| 1265047351 | Taylor Clark | Physical Therapist | 1015 W 47th Street, Norfolk, VA 23508 | 2020-09-15 |
| Find all providers in zip 23508 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538788252 | Travis Hasan May | Specialist/Technologist | 3175 Azalea Garden Rd Ste D, Norfolk, VA 23513-2363 | 2020-04-13 |
| 1831725209 | Rebecca Potter | Specialist/Technologist | 312 W Bute St Ste 100, Norfolk, VA 23510-1302 | 2020-03-18 |
| 1780215160 | Catalina Silva | Specialist/Technologist | 4251 Powhatan Ave Rm 1001, Norfolk, VA 23508-2225 | 2020-02-04 |
| 1447818950 | Andrea L Bogner | Specialist/Technologist | 1630 Hackberry Dr, Norfolk, NE 68701-3332 | 2019-05-30 |
| 1912564311 | Briana M Lawry | Specialist/Technologist | 4608 Hampton Blvd, Norfolk, VA 23529-0001 | 2019-05-22 |
| 1114581931 | Kathleen S Thomas | Specialist/Technologist | 700 Park Avenue Brc-110, Norfolk, VA 23504 | 2019-04-26 |
| 1891266318 | Zachary Kershaw | Specialist/Technologist | 7101 Granby St, Norfolk, VA 23505-4013 | 2018-12-10 |
| 1679054035 | Charles Marshall Mozena | Specialist/Technologist | 4700 Powhatan Avenue, Norfolk, VA 23529-0001 | 2018-08-23 |
| 1326548140 | Trevor Thompson | Specialist/Technologist | Old Dominion University 5115 Hampton Blvd, Norfolk, VA 23529-0001 | 2018-02-19 |
| 1104335629 | Michael Andrew Burkeitt | Specialist/Technologist | 4500 Parker Avenue, Norfolk, VA 23529-0001 | 2017-09-27 |
| Find all providers in NORFOLK | ||||
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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.