Amy Melissa Wiedlich, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015077 Issued in PA

Practice address

119 S Main Rd
Mountain Top, PA 18707-1903

Phone

(570) 208-5571

Fax

(570) 208-5548

NPI assigned

Jul 26, 2010

Last updated

Jul 26, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Specialty Physical Therapy LLC

  • Physical Therapist
  • Wyoming, PA
  • NPI 1013548379
  NPD
• Gem Therapeutics

  • Physical Therapist
  • Dallas, PA
  • NPI 1871519504
  NPD (past)

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1043523541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MAIN ST",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186121603",
            "telephone_number": "570-208-5571",
            "fax_number": "570-208-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S MAIN RD",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071903",
            "telephone_number": "570-208-5571",
            "fax_number": "570-208-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDLICH",
        "first_name": "AMY",
        "middle_name": "MELISSA",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Waite, RD
• Aaron Wanchisen, RPH
• Weis Markets Inc (Weis Pharmacy)
• Annika Kristin Wessel, DMD
• Jennifer A. Wheeler, MD
• Devon Woolfolk, PA-C
• Katlyn Michelle Yackoski, M.S., CCC-SLP
• John Joseph Yuscavage, PHD
• Michelle Lee Zapotoski, LPC, NCC
• Brenda Zavistoski, RN

• Physical Therapist in Mountain Top, PA
• Providers in Mountain Top, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.