NPIMap

Organization Active NPI

Wichita Physical Therapy Group, LLC

Doing business as Wichita Physical Therapy Group

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1306429345
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
WICHITA PHYSICAL THERAPY GROUP, LLC
Doing business as
Wichita Physical Therapy Group
Practice address
2146 N Collective LN Ste 114
Wichita, KS 67206-3574
Phone
(316) 259-6494
NPI assigned
Apr 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Mr. Jonathan Yates Harris, PHYSICAL THERAPISTNPI 1336160134
Title
Owner
Phone
(316) 358-9942

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2146 N Collective LN Ste 114
Wichita, KS 67206-3574

Mailing address

2146 N Collective LN Ste 114
Wichita, KS 67206-3574

Other names 1

  • Wichita Physical Therapy Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210608001282 KS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8325448616 Receives reassigned benefits from 4 practitioners
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory
Tax ID family
Wichita Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1306429345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2146 N COLLECTIVE LN STE 114",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2146 N COLLECTIVE LN STE 114",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063574",
            "telephone_number": "316-259-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA PHYSICAL THERAPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "YATES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-358-9942",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wichita Physical Therapy Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.