Individual provider Active NPI

Briana Wyatt, PT, DPT

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1265078794
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34703 Issued in FL
Practice address
6870 Alister Way
Fort Myers, FL 33912-4535
Phone
(239) 210-5483
NPI assigned
Nov 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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 34703 FL Primary

Addresses

Primary practice location

6870 Alister Way
Fort Myers, FL 33912-4535

Mailing address

8096 Pelican Rd
Fort Myers, FL 33967-3464
Phone (630) 415-4638

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

LicenseStateTypeSpecialty
34703FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Health Physical Therapy and Wellness Current Accepting new patients

Organizations & group practices 1

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": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1265078794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8096 PELICAN RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339673464",
            "telephone_number": "630-415-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6870 ALISTER WAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124535",
            "telephone_number": "239-210-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "BRIANA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "34703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.