Individual provider Active NPI

Wilmer Paul Deshner, PT

  • Physical Therapy Clinic/Center
  • Gridley, CA
National Provider Identifier
1215416425
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PTP--PT-LIC-1060 Issued in MT
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, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PTP--PT-LIC-1060MTMDPhysical 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.

Verify at the official NPI Registry.