Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Leslie Diane Wilson, PT

Individual provider Physical Therapist · NPI 1639424799

Leslie Diane Wilson, PT is a Physical Therapist in Private Practice in Southaven, Mississippi. Graduated from Northeastern Ohio University College of Medicine in 2012, 14 years ago. Practices with Cleveland Orthopedic and Spine Institute, LLC, a 16-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Mississippi and Ohio.

Years since qualifying
14
Trained at
Northeastern Ohio University College of Medicine
Licensed in
MS, OH
In the registry since
2012
Specialties on file
3
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

3451 Goodman Rd E Ste 108
Southaven, MS 38672-9305
Phone: (662) 890-6953
Fax: (662) 890-6954
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 7277 Smiths Mill Rd Ste 100, New Albany, OH 43054-8195 — (614) 304-2123
  • 45280 National Rd, Saint Clairsville, OH 43950-8787 — (740) 247-7955
  • 8066 Walnut Run Rd, Cordova, TN 38018-8841 — (901) 759-9210

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT5223 (MS)
Physical Therapist Taxonomy 225100000X · Licence PT017702 (OH)
Orthopedic Physical Therapist Taxonomy 2251X0800X · Licence PT017702 (OH)

Record details

NPI number1639424799
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedJuly 16, 2012
Last updated in NPPESMarch 25, 2025
Certification dateMarch 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolNORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Cleveland Orthopedic And Spine Institute, Llc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Southaven