Kelsey Wilde, DPT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

60690 Issued in OR

Practice address

441 Werth Blvd.
Newberg, OR 97123

Phone

(503) 538-9436

NPI assigned

Jul 16, 2014

Last updated

Aug 20, 2014By 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

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Premere Rehab LLC

  dba Infinity Rehab

  • Physical Therapist
  • Wilsonville, OR
  • NPI 1245278639
  Medicare reassignment NPD

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1427465962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 WERTH BLVD.",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "97123",
            "telephone_number": "503-538-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 WERTH BLVD.",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "97123",
            "telephone_number": "503-538-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "KELSEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "OR",
            "license": "60690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Viva Wheaton, PSY.D.
• Amethyst White, FNP-C
• Kenneth A Whittaker, MD
• Mary Teresa Wikander, LCSW
• Timothy P Wilcox, LMT
• Robert Carl Wilde, DMD
• Hannah Elisabeth Wiley, LMT
• Willamette Valley Mental Health LLC
• Willamette Valley Mental Health LLC
• Willamette Valley Rheumatolgy PC

• Geriatric Physical Therapist in Newberg, OR
• Providers in Newberg, OR by specialty
• Geriatric Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.