Active NPI
Brian Wohlgemuth
- Physical Therapy Assistant
- Los Angeles, CA
National Provider Identifier
1003469149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A-1149
- Practice address
- 2929 Waverly Dr Apt 318
Los Angeles, CA 90039-4111 - Phone
- (323) 986-9999
- NPI assigned
- Jul 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A-1149 | NV | Primary |
Addresses
Primary practice location
2929 Waverly Dr Apt 318
Los Angeles, CA 90039-4111
Mailing address
2929 Waverly Dr Apt 318
Los Angeles, CA 90039-4111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-1149 | NV | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563408000000",
"number": "1003469149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 WAVERLY DR APT 318",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900394111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 WAVERLY DR APT 318",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900394111",
"telephone_number": "323-986-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOHLGEMUTH",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-18",
"last_updated": "2019-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NV",
"license": "A-1149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.