Individual provider Active NPI

Courtland Wyatt, P.T.

  • Physical Therapist
  • Washington, DC
National Provider Identifier
1003846676
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2863 Issued in DC
Practice address
3700 N Capitol St NW
Washington, DC 20011-8400
Phone
(800) 422-9988
Fax
(301) 262-1259
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2863 DC Primary

Addresses

Primary practice location

3700 N Capitol St NW
Washington, DC 20011-8400

Mailing address

6196 Oxon Hill Rd
Ste 120
Oxon Hill, MD 20745-3138
Phone (301) 567-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000576 DC Practitioner - Physical Therapist in Private Practice 2365544947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6130 Oxon Hill Rd
Suite 102
Oxon Hill, MD 20745-3166
Phone (301) 882-8511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19708MDMDClinical Social Worker
PT2863DCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
American Continuing Education Solutions Physical Therapist CurrentSince Sep 15, 2021 Accepting new patients
American Continuing Education Solutions CurrentSince Sep 15, 2021 Accepting new patients
Ergo Home Health Physical Therapist Current Accepting new patients

Locations

1250 Connecticut Ave NW
Ste 700
Washington, DC 20036
Phone (202) 261-6598

9001 Woodyard Rd
Ste D
Clinton, MD 20735
Phone (240) 244-2012

6130 Oxon Hill Rd
Ste 102
Oxon Hill, MD 20745
Phone (240) 604-8757

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1003846676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6196 OXON HILL RD",
            "address_2": "STE 120",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453138",
            "telephone_number": "301-567-6400",
            "fax_number": "202-318-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N CAPITOL ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200118400",
            "telephone_number": "800-422-9988",
            "fax_number": "301-262-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "COURTLAND",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT2863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.