Kelley S Wiedmeyer-Davis, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7630 Issued in NC

Practice address

3701 NW Cary Parkway
Suite 301
Cary, NC 27513

Phone

(919) 388-0111

Fax

(919) 388-8668

NPI assigned

Jul 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dunn Physical Therapy Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1174540512
  NPD (past)
• Total Body Rehab, LLC

  • Physical Therapy Clinic/Center
  • Cary, NC
  • NPI 1831224989
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427075886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 NW CARY PARKWAY",
            "address_2": "SUITE 301 DUNN PHYSICAL THERAPY",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-388-0111",
            "fax_number": "919-388-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 NW CARY PARKWAY",
            "address_2": "SUITE 301",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-388-0111",
            "fax_number": "919-388-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDMEYER-DAVIS",
        "first_name": "KELLEY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "7630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0784Q",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5102400",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6698931",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2209325",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Anne Wicki
• Widrick Occupational Therapy Services, PLLC
• Danielle Widrick, PTA
• Dean Widrick, MS, OTR/L
• Natalie Rose Wieand, O.D.
• Susan Wieland, OTR/L
• Zachary M Wiercinski, NP
• Josiane S Wiggins, LMBT
• Ni'Yani Wiggins
• Rebecca Wight

• Physical Therapist in Cary, NC
• Providers in Cary, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.