Active NPI
Patrick Wills
- Physical Therapist
- Cantonment, FL
National Provider Identifier
1356827448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT35957
- Practice address
- 1170 W Roberts Rd
Cantonment, FL 32533-8317 - Phone
- (901) 493-2238
- NPI assigned
- Jul 12, 2018
- Last updated
- Jan 6, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11801 | TN | |
| Physical Therapist | 225100000X | PT35957 | FL | Primary |
Addresses
Primary practice location
1170 W Roberts Rd
Cantonment, FL 32533-8317
Mailing address
1170 W Roberts Rd
Cantonment, FL 32533-8317
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11801 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1356827448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 W ROBERTS RD",
"city": "CANTONMENT",
"state": "FL",
"postal_code": "325338317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 W ROBERTS RD",
"city": "CANTONMENT",
"state": "FL",
"postal_code": "325338317",
"telephone_number": "901-493-2238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLS",
"first_name": "PATRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-12",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "11801",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT35957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cantonment, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.