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

Mr. Kevin David Wilson

Individual provider Physical Therapist · NPI 1104890128

Mr. Kevin David Wilson is a Physical Therapist in Private Practice in Miamisburg, Ohio. Qualified in 2003, 23 years ago. Practices with Beacon Orthopaedics and Sports Medicine Ltd, a 471-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
23
Licensed in
OH
In the registry since
2006

Practice location Address checks out

2835 Miami Village Dr
Miamisburg, OH 45342-4587
Phone: (937) 449-0796
Fax: (937) 262-7468
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT010461 (OH)

Record details

NPI number1104890128
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 15, 2006
Last updated in NPPESSeptember 10, 2019
Mailing address6480 Harrison Ave Ste 201, Cincinnati, OH 45247-7961

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Beacon Orthopaedics And Sports Medicine Ltd — 471 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Miamisburg