Active NPI
David Edwin Wiley, PT
- Physical Therapist
- Lansing, IA
National Provider Identifier
1295059244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4399-24
- Practice address
- 1656 Village Creek Dr
Lansing, IA 52151-7571 - Phone
- (608) 386-0372
- NPI assigned
- Mar 19, 2010
- Last updated
- Mar 19, 2010
- Sex
- Male
- 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 | 4399-24 | WI | Primary |
Addresses
Primary practice location
1656 Village Creek Dr
Lansing, IA 52151-7571
Mailing address
PO Box 553
Lansing, IA 52151-0553
Phone (608) 386-0372
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4399-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268956800000",
"number": "1295059244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 553",
"city": "LANSING",
"state": "IA",
"postal_code": "521510553",
"telephone_number": "608-386-0372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1656 VILLAGE CREEK DR",
"city": "LANSING",
"state": "IA",
"postal_code": "521517571",
"telephone_number": "608-386-0372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "DAVID",
"middle_name": "EDWIN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-19",
"last_updated": "2010-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "4399-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.