Active NPI
Kirsten Marshall Wiley, MPT
- Physical Therapist
- Coronado, CA
National Provider Identifier
1265601165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT33886
- Practice address
- 842 B Ave
Coronado, CA 92118-2616 - Phone
- (619) 522-0544
- NPI assigned
- Feb 25, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT33886 | CA | Primary |
Addresses
Primary practice location
842 B Ave
Coronado, CA 92118-2616
Mailing address
842 B Ave
Coronado, CA 92118-2616
Phone (619) 522-0544
Other names 1
- Kirsten Marshall Conover
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33886 | CA | MD | Dental Hygienist |
| PT33886 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1265601165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "842 B AVE",
"city": "CORONADO",
"state": "CA",
"postal_code": "921182616",
"telephone_number": "619-522-0544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "842 B AVE",
"city": "CORONADO",
"state": "CA",
"postal_code": "921182616",
"telephone_number": "619-522-0544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "KIRSTEN",
"middle_name": "MARSHALL",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-25",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT33886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIRSTEN",
"last_name": "CONOVER",
"middle_name": "MARSHALL",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Coronado, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.