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

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

State licenses

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 and National Provider Directory roles.

• Premere Rehab LLC

  • 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.