Active NPI
Michael Allan Wheeler, PTA
- Physical Therapy Assistant
- Phoenix, AZ
National Provider Identifier
1013114057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A2451
- Practice address
- 7540 N 19TH Avenue
Phoenix, AZ 85021-7967 - Phone
- (602) 324-6500
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- Sole proprietor
- No
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 | A2451 | MD | Primary |
Addresses
Primary practice location
7540 N 19TH Avenue
Phoenix, AZ 85021-7967
Mailing address
18 Furrow Lane
North East, MD 21901-1137
Phone (410) 658-9730
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 |
|---|---|---|---|
| A2451 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013114057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 FURROW LANE",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "219011137",
"telephone_number": "410-658-9730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7540 N 19TH AVENUE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850217967",
"telephone_number": "602-324-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "MICHAEL",
"middle_name": "ALLAN",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A2451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.