Amy Wibholm, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004842 Issued in IA

Practice address

1215 Duff Ave
Ames, IA 50010-5400

Phone

(515) 956-4095

Fax

(515) 956-4093

NPI assigned

Oct 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McFarland Clinic PCGroup PAC ID 1254244239, 353 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awibholm63017@directmcfarlandclinic.com

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

• McFarland Clinic PC

  • Multi-Specialty Clinic/Center
  • Ames, IA
  • NPI 1639135643
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1225312390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DRIVE",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606030000",
            "telephone_number": "312-640-0329",
            "fax_number": "312-640-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 DUFF AVE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500105400",
            "telephone_number": "515-956-4095",
            "fax_number": "515-956-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBHOLM",
        "first_name": "AMY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awibholm63017@directmcfarlandclinic.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1215 Duff Ave",
            "city": "Ames",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500105400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barb J Wheelock, PT
• Stephen John White, MS, LCGC
• Alex Whitham, DNP, FNP-C
• Megan Joy Whitson, LMSW
• Samuel A Whittier, MD
• Alexander Wickenkamp, MD
• Chelsea Sue Wickman, ARNP
• Anna Wilcox, MD
• Leah Wilcox, BT
• Lee Wilkins, MD

• Physical Therapist in Ames, IA
• Providers in Ames, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.