Active NPI
Ian Woytus, PT, DPT
- Physical Therapist
- Henderson, NV
National Provider Identifier
1053850610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4053
- Practice address
- 2821 W. Horizon Ridge Pkwy
Suite # 101
Henderson, NV 89052 - Phone
- (702) 893-3333
- Fax
- (702) 893-0960
- NPI assigned
- Feb 15, 2017
- Last updated
- Oct 18, 2021
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 27229 | MD | |
| Physical Therapist | 225100000X | 17876 | NC | |
| Physical Therapist | 225100000X | 11544 | TN | |
| Physical Therapist | 225100000X | 2305212001 | VA | |
| Physical Therapist | 225100000X | 60697660 | WA | |
| Physical Therapist | 225100000X | 1281955 | TX | |
| Physical Therapist | 225100000X | 4053 | NV | Primary |
Addresses
Primary practice location
2821 W. Horizon Ridge Pkwy
Suite # 101
Henderson, NV 89052
Mailing address
2821 W. Horizon Ridge Pkwy
Suite # 101
Henderson, NV 89052
Phone (702) 893-3333
Other practice location 1
1108 E 1st St
Port Angeles, WA 98362-4317
Phone (360) 452-6216
Other practice location 2
9707 Medical Center Dr Ste 330
Rockville, MD 20850-6343
Phone (301) 444-4090
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053850610 | Medicaid | VA | |
| G8967218 | Other | WA | MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27229 | MD | MD | Social Worker |
| 11544 | TN | MD | Pharmacist |
| 17876 | NC | MD | Physical Therapist |
| 4053 | NV | MD | Physical Therapist |
| 1281955 | TX | MD | Physical Therapist |
| 2305212001 | VA | MD | Physical Therapist |
| 60697660 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634515200000",
"number": "1053850610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 W. HORIZON RIDGE PKWY",
"address_2": "SUITE # 101",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89052",
"telephone_number": "702-893-3333",
"fax_number": "702-893-0960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2821 W. HORIZON RIDGE PKWY",
"address_2": "SUITE # 101",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89052",
"telephone_number": "702-893-3333",
"fax_number": "702-893-0960"
}
],
"practiceLocations": [
{
"address_1": "1108 E 1st St",
"address_purpose": "LOCATION",
"city": "Port Angeles",
"state": "WA",
"postal_code": "983624317",
"country_code": "US",
"telephone_number": "360-452-6216",
"fax_number": "360-452-8765",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9707 Medical Center Dr Ste 330",
"address_purpose": "LOCATION",
"city": "Rockville",
"state": "MD",
"postal_code": "208506343",
"country_code": "US",
"telephone_number": "301-444-4090",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOYTUS",
"first_name": "IAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-15",
"last_updated": "2021-10-18",
"certification_date": "2021-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "27229",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "17876",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "11544",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305212001",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "60697660",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1281955",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "4053",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1053850610",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "G8967218",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.