Individual provider Active NPI

Megan L Wiedenmann, DPT

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1255838504
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-03832 Issued in KS
Practice address
5002 E Central Ave Ste B
Wichita, KS 67208-4167
Phone
(913) 439-7279
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-03832 KS Primary

Addresses

Primary practice location

5002 E Central Ave Ste B
Wichita, KS 67208-4167

Mailing address

15915 E Boxthorn St
Wichita, KS 67228-8118
Phone (913) 439-7279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727002946 KS Practitioner - Physical Therapist in Private Practice 5799167490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Center for Therapy PAGroup PAC ID 7214318336, 2 clinicians

Practice addresses (Care Compare)

125 S W St
Suite 111
Wichita, KS 67213-2114
Phone (316) 260-3934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-03832KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Center for Therapy P.a. Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
In Control Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

223 S Hillside St
Wichita, KS 67211
Phone (316) 260-3934

125 S West St
Ste 111
Wichita, KS 67213
Phone (316) 260-3934

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1255838504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15915 E BOXTHORN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672288118",
            "telephone_number": "913-439-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 E CENTRAL AVE STE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084167",
            "telephone_number": "913-439-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDENMANN",
        "first_name": "MEGAN",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.