NPIMap

Organization Active NPI

Wise Physical Therapy and Rehabilitation Inc.

  • Physical Therapist
  • Anchorage, AK
National Provider Identifier
1164629853
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
742039 Issued in AK
Legal business name
WISE PHYSICAL THERAPY AND REHABILITATION INC.
Practice address
1200 Airport Heights Dr Ste 170
Anchorage, AK 99508-2986
Phone
(907) 562-2118
Fax
(907) 562-2128
NPI assigned
Jun 27, 2007
Last updated
Aug 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John W. Wise, PTNPI 1881779817
Title
President
Phone
(907) 562-2118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 742039 AK Primary

Addresses

Primary practice location

1200 Airport Heights Dr Ste 170
Anchorage, AK 99508-2986

Mailing address

1200 Airport Heights Dr Ste 170
Anchorage, AK 99508-2986
Phone (907) 562-2118

Other identifiers 1

IdentifierTypeStateIssuer
1021187MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070716000392 AK Part B Supplier - Clinic/Group Practice 5597865840 Receives reassigned benefits from 14 practitioners
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

2612 Eagle St
Anchorage, AK 99503
Phone (907) 562-2118

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1164629853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 AIRPORT HEIGHTS DR STE 170",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082986",
            "telephone_number": "907-562-2118",
            "fax_number": "907-562-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 AIRPORT HEIGHTS DR STE 170",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082986",
            "telephone_number": "907-562-2118",
            "fax_number": "907-562-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE PHYSICAL THERAPY AND REHABILITATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-562-2118",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "742039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021187",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.