Active NPI
Karen L Wimmer
- Pediatric Physical Therapist
- San Antonio, TX
National Provider Identifier
1255822722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1036507
- Practice address
- 1003 Beckett Ste 201
San Antonio, TX 78213-1372 - Phone
- (210) 998-2330
- NPI assigned
- May 21, 2018
- Last updated
- May 21, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1036507 | TX | |
| Pediatric Physical Therapist | 2251P0200X | 1036507 | TX | Primary |
Addresses
Primary practice location
1003 Beckett Ste 201
San Antonio, TX 78213-1372
Mailing address
912 Arroweye TRL
Austin, TX 78733-1807
Phone (512) 773-0852
Other practice location 1
5000 Bee Caves Rd Ste 206
West Lake Hills, TX 78746-5552
Phone (512) 284-8964
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 |
|---|---|---|---|
| 1036507 | TX | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mlee SLP LLC | Past | Accepting new patients | |
| Mlee-SLP, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526860800000",
"number": "1255822722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 ARROWEYE TRL",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787331807",
"telephone_number": "512-773-0852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 BECKETT STE 201",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782131372",
"telephone_number": "210-998-2330"
}
],
"practiceLocations": [
{
"address_1": "5000 Bee Caves Rd Ste 206",
"address_purpose": "LOCATION",
"city": "West Lake Hills",
"state": "TX",
"postal_code": "787465552",
"country_code": "US",
"telephone_number": "512-284-8964",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIMMER",
"first_name": "KAREN",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-21",
"last_updated": "2018-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1036507",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "TX",
"license": "1036507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.