Wyatt Robert Wichman

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

03316548 Issued in CA

Practice address

100 W Broadway Ste 750
Glendale, CA 91210-1215

Phone

(323) 419-4103

Fax

(323) 419-5507

NPI assigned

Jan 10, 2020

Last updated

Jan 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Pleasant Point PT, Corp.

  • Physical Therapist
  • Glendale, CA
  • NPI 1528608825

  Physical Therapy

  NPD

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1265072904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W BROADWAY STE 750",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912101215",
            "telephone_number": "323-419-4103",
            "fax_number": "323-419-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W BROADWAY STE 750",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912101215",
            "telephone_number": "323-419-4103",
            "fax_number": "323-419-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMAN",
        "first_name": "WYATT",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "03316548",
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "CA",
            "license": "03316548",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY AGENCY",
            "identifier": "03316548",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pleasant@ptpoint.org",
            "affiliation": "N",
            "endpointDescription": "HIPPA Regulated Email Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 W Broadway Ste 750",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912101215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Marshall White, PMHNP-BC
• Jessica Whittington
• Whole Family Health, PC
• Whole Heart Home Health Agency, Inc.
• Beata Anna Wicherski, MD
• Emily V H Wieber, LMFT
• Ciara Marie Wiggins
• David Wilhoite
• William F. Reynolds, M.D., Inc.
• William W Loebman, M.D., Inc

• Physical Therapy Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.