Jay Wiles, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1940-19 Issued in WI

Practice address

200 N 7TH Ave
Sturgeon Bay, WI 54235-1708

Phone

(920) 743-5274

NPI assigned

May 15, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1245676352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3364 S WILLOW RD",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542358695",
            "telephone_number": "712-635-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N 7TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351708",
            "telephone_number": "920-743-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "JAY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1940-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis K White, PH.D.
• Nicolette White
• Deborah L Whitelaw Gorski, OTR
• Paul M Whitelaw-Gorski, OTR
• Leah Rose Wiegand, LPN
• Wisconsin CVS Pharmacy, L.L.C.
• Brett D Young, MD
• Zablocki VA Medical Center
• Cynthia Marie Zellner-Ehlers, LSW
• Elizabeth Ziolkowski, LPC-IT

• Physical Therapy Assistant in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.