Jennifer M Wisham, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008975 Issued in GA

Practice address

665 Gaines School Rd.
Athens, GA 30605

Phone

(706) 369-8115

NPI assigned

Mar 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• East Athens Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Athens, GA
  • NPI 1326082611
  NPD (past)
• Life Clinic of Ga PC

  • Chiropractor
  • Woodstock, GA
  • NPI 1922752807

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285751354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BLACK OAK CT",
            "city": "CRAWFORD",
            "state": "GA",
            "postal_code": "306301900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 GAINES SCHOOL RD.",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30605",
            "telephone_number": "706-369-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHAM",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Callaway Wingfield, PTA
• Kasha Wingfield
• Kizzy Mae Wingfield, M.ED, CADC II
• Serah Elizabeth Winkler
• Sabrina Ann Wise, PTA
• Payton Jamison Witt
• Stephanie Witt, NP
• Victoria Wnuck
• Enyam Claude Woanyah, MD
• Noah Woford, DO

• Physical Therapist in Athens, GA
• Providers in Athens, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.