Wyatt C Jordan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTP-PT-LIC-21996 Issued in MT

Practice address

200 E Idaho St Ste a
Kalispell, MT 59901-4117

Phone

(406) 257-5610

Fax

(406) 257-1372

NPI assigned

Aug 31, 2021

Last updated

Dec 1, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in MT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kalispell Rehabilitation Associates IncGroup PAC ID 9830183961, 12 clinicians

Lake Health and Rehab, LLCGroup PAC ID 6901059963, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kalispell Rehabilitation Associates, Inc

  dba Professional Therapy Associates

  • Physical Therapist
  • Kalispell, MT
  • NPI 1497752232
  Medicare reassignment Care Compare group NPD
• Lake Health & Rehab, LLC

  dba Professional Therapy Associates

  • Physical Therapist
  • Lakeside, MT
  • NPI 1538417233
  Medicare reassignment Care Compare group NPD
• Professional Therapy Associates

  • Physical Therapist
  • Kalispell, MT
  • NPI 1649269358
  NPD (past)

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1093483406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-300-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E IDAHO ST STE A",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014117",
            "telephone_number": "406-257-5610",
            "fax_number": "406-257-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "WYATT",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "PTP-PT-LIC-21996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Jones
• Susan Elizabeth Jones, DC
• William Junis Jones, D.D.S.
• Lindsey Marie Jordan, LCSW
• Robert Y. Jordan, M.S. CTRS
• Mary Lynn Jordt, LCSW
• Torbjorn Ingvar Joreteg, MD PHD
• Joy Weaks, LCPC
• Timothy Andrew Joyce, M.D.
• Julien Marsh (All Families Healthcare)

• Physical Therapist in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.