Active NPI
Zyon Emanuel Wiley
- Physical Therapist
- Hagerstown, MD
National Provider Identifier
1073457404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 30730
- Practice address
- 17301 Valley Mall Rd Ste 125
Hagerstown, MD 21740-6966 - Phone
- (301) 790-9238
- Fax
- (240) 752-6033
- NPI assigned
- Apr 16, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 Therapist | 225100000X | 30730 | MD | Primary |
Addresses
Primary practice location
17301 Valley Mall Rd Ste 125
Hagerstown, MD 21740-6966
Mailing address
12401 Beachley Dr
Hagerstown, MD 21740-2045
Phone (301) 790-9238
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 |
|---|---|---|---|
| 30730 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776297600000",
"number": "1073457404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12401 BEACHLEY DR",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217402045",
"telephone_number": "301-790-9238",
"fax_number": "240-752-6033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17301 VALLEY MALL RD STE 125",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217406966",
"telephone_number": "301-790-9238",
"fax_number": "240-752-6033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "ZYON",
"middle_name": "EMANUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-16",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "30730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.