Katherine Mary Wybo, M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501010889 Issued in MI

Practice address

13365 Victoria Ave
Huntington Woods, MI 48070-1720

Phone

(248) 765-3153

NPI assigned

Feb 26, 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

State licenses

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.

• Lifespan Therapy & Wellness, LLC

  • Physical Therapist
  • Washington Township, MI
  • NPI 1669626289
  NPD (past) Authorized official

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1316073893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13365 VICTORIA AVE",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701720",
            "telephone_number": "248-765-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13365 VICTORIA AVE",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701720",
            "telephone_number": "248-765-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYBO",
        "first_name": "KATHERINE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Christina Williams
• Ronnie Thomas Williamson, DDS
• Herbert Karl Winter, DDS
• Vanessa Wood, LMT
• Nicholas Allen Wright, LMT
• Your Dental Connection D.D.S., P.C.
• Angela Zarek
• Maya Ziegler, LMT
• Jennifer M Zoltowski, MS, LLP

• Physical Therapist in Huntington Woods, MI
• Providers in Huntington Woods, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.