Individual provider Active NPI

Delany B Wilkes, DPT

  • Physical Therapist
  • Bangor, ME
National Provider Identifier
1063785194
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3808 Issued in ME
Practice address
12 Stillwater Ave
Bangor, ME 04401-3984
Phone
(207) 945-2946
NPI assigned
Feb 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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 PT3808 ME Primary

Addresses

Primary practice location

12 Stillwater Ave
Bangor, ME 04401-3984

Mailing address

1026 Main St
Apt. 1
Veazie, ME 04401-7056
Phone (207) 794-4393

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

LicenseStateTypeSpecialty
PT3808MEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1063785194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 MAIN ST",
            "address_2": "APT. 1",
            "city": "VEAZIE",
            "state": "ME",
            "postal_code": "044017056",
            "telephone_number": "207-794-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013984",
            "telephone_number": "207-945-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "DELANY",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.