Jennifer Wysock, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

4900 SE Willoughby Blvd
Stuart, FL 34997-4002

Phone

(772) 781-4503

NPI assigned

Sep 12, 2019

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1063062909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 SW WILLOWBEND LN",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349908412",
            "telephone_number": "772-485-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 SE WILLOUGHBY BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349974002",
            "telephone_number": "772-781-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCK",
        "first_name": "JENNIFER",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Wroblewski, PHARMD
• Dana Wuchte
• Amber Dawn Wyatt Herald
• Kimberly Sue Wyatt, MD
• Toni-Ann Wynn
• Teresa Yancey
• Luis Yanez, ARNP
• Joo Hee Yang
• Destiny Star Yarbrough, MS, RD
• Amanda Yassin

• Physical Therapy Assistant in Stuart, FL
• Providers in Stuart, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.

Verify at the official NPI Registry.