JUSTINE BREANNE WILSON DPT
NPI 1871130583
Physical Therapist in Phoenix, AZ

Active since December 02, 2019
11811 N TATUM BLVD STE 3031, PHOENIX, AZ 85028(602) 708-8091(602) 218-6462 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Justine Breanne Wilson Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTINE BREANNE WILSON DPT (NPI 1871130583) is an individual physical therapist in Phoenix, Arizona, licensed in Washington (PT60957709) and active in the NPI registry since December 2019.

NPPES Registry Identity

NPI1871130583
Entity TypeIndividualFemale
Primary Taxonomy225100000X
Provider Legal NameJUSTINE BREANNE WILSONCredential: DPT
Location Address11811 N TATUM BLVD STE 3031Phoenix, AZ 85028-1621
Mailing Address11811 N Tatum Blvd Ste 3031Phoenix, AZ 85028-1621 · (602) 708-8091 · Fax (602) 218-6462
Fax(602) 218-6462
Sole ProprietorNo
Enumeration DateDecember 2, 2019
Last NPPES UpdateAugust 2, 2023
NPPES CertifiedJuly 26, 2023
✔ NPI 1871130583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in WA · PT60957709
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
11811 N TATUM BLVD STE 3031, Phoenix, AZ 85028

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justine Breanne Wilson Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Justine Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Home Health
11811 N TATUM BLVD STE 3031
Phoenix, AZ 85028
  • Reassigned Medicare billing, Arizona enrollment
  • 26 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Home Health
11811 N TATUM BLVD STE 3031
PHOENIX, AZ 85028
Counselor (Mental Health)
11811 N TATUM BLVD STE 3031
PHOENIX, AZ 85028
Counselor (Mental Health)
11811 N TATUM BLVD STE 3031
PHOENIX, AZ 85028
Counselor (Mental Health)
11811 N TATUM BLVD STE 3031
PHOENIX, AZ 85028
Occupational Therapist
11811 N TATUM BLVD STE 3031
PHOENIX, AZ 85028
Social Worker
11811 N TATUM BLVD STE 3031
PHOENIX, AZ 85028
Specialist/Technologist (Speech-Language Assistant)
11811 N TATUM BLVD STE 3031
PHOENIX, AZ 85028
Hospice Care, Community Based
11811 N TATUM BLVD STE 3031
PHOENIX, AZ 85028

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justine Wilson's NPI number?

The NPI number for Justine Wilson is 1871130583. It was assigned to this individual provider in the NPPES registry on December 2, 2019.

Where is Justine Wilson located?

Justine Wilson practices at 11811 N Tatum Blvd Ste 3031, Phoenix, AZ 85028. The listed phone number is (602) 708-8091.

What is Justine Wilson's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Justine Wilson enrolled in Medicare?

Yes. Justine Wilson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Justine Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justine Wilson reassigns Medicare benefits to Wheels On The Bus, Inc. (Phoenix, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justine Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Justine Wilson was last updated on August 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.