Active NPI
Kalan Wyatt
- Physical Therapist
- Terre Haute, IN
National Provider Identifier
1386230225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 5399 S US Highway 41 Ste 113
Terre Haute, IN 47802-4781 - Phone
- (812) 298-8883
- NPI assigned
- Dec 15, 2020
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
5399 S US Highway 41 Ste 113
Terre Haute, IN 47802-4781
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1386230225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5399 S US HIGHWAY 41 STE 113",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478024781",
"telephone_number": "812-298-8883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "KALAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-15",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.