Active NPI
Wilmer Paul Deshner, PT
- Physical Therapy Clinic/Center
- Gridley, CA
National Provider Identifier
1215416425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- PTP--PT-LIC-1060
- Practice address
- 240 Spruce St
Gridley, CA 95948-2216 - Phone
- (530) 846-9000
- Fax
- (530) 846-9027
- NPI assigned
- Aug 8, 2018
- Last updated
- Aug 8, 2018
- 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 Therapy Clinic/Center | 261QP2000X | PTP--PT-LIC-1060 | MT | Primary |
Addresses
Primary practice location
240 Spruce St
Gridley, CA 95948-2216
Mailing address
5041 Victor CT
Missoula, MT 59803-9678
Phone (406) 396-3240
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 |
|---|---|---|---|
| PTP--PT-LIC-1060 | MT | MD | Physical Therapy Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533686400000",
"number": "1215416425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5041 VICTOR CT",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598039678",
"telephone_number": "406-396-3240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 SPRUCE ST",
"city": "GRIDLEY",
"state": "CA",
"postal_code": "959482216",
"telephone_number": "530-846-9000",
"fax_number": "530-846-9027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESHNER",
"first_name": "WILMER",
"middle_name": "PAUL",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-08",
"last_updated": "2018-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "MT",
"license": "PTP--PT-LIC-1060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gridley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.