Wendy Jean Booker, PT

Individual provider Active NPI Physical Therapist · Clearwater, KS

NPI 1295955094 · NPPES record last updated Aug 25, 2020

Key facts

NPI
1295955094
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
11-02803 (KS)
Practice address
108 E Ross St
Clearwater, KS 67026-7821
Phone
(620) 584-3777
Fax
(620) 584-6777
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
11-02803KSMDPhysical Therapist
3593OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Via Christi Rehabilitation Hospital, Inc. Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-02803 KS Yes

Addresses

Primary practice location

108 E Ross St
Clearwater, KS 67026-7821

Mailing address

485 N KS Hwy 2
Anthony, KS 67003-2526
Phone (620) 914-1200

Other providers in Clearwater, KS

All providers in Clearwater, KS · Physical Therapist in Kansas

Sources for this page

Verify at the official NPI Registry.