Active NPI
Bradley Wilt, DPT
- Physical Therapist
- Sylvania, OH
National Provider Identifier
1083189559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501017152
- Practice address
- 5855 Monroe St
Sylvania, OH 43560-2269 - Phone
- (419) 276-7130
- NPI assigned
- Oct 10, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501017152 | MI | Primary |
Addresses
Primary practice location
5855 Monroe St
Sylvania, OH 43560-2269
Mailing address
4851 S Arvilla Dr
Toledo, OH 43623-1011
Phone (216) 973-5170
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 |
|---|---|---|---|
| 5501017152 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539129600000",
"number": "1083189559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4851 S ARVILLA DR",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436231011",
"telephone_number": "216-973-5170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5855 MONROE ST",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435602269",
"telephone_number": "419-276-7130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILT",
"first_name": "BRADLEY",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-10",
"last_updated": "2018-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501017152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylvania, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.