Individual provider Active NPI

Nicholas Wyrosdick, DPT

  • Physical Therapist
  • Arlington, TN
National Provider Identifier
1447865985
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5226 Airline Rd Ste 131
Arlington, TN 38002-9939
Phone
(901) 441-7997
Fax
(901) 881-1577
NPI assigned
Sep 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6991 MS
Physical Therapist 225100000X Primary

Addresses

Primary practice location

5226 Airline Rd Ste 131
Arlington, TN 38002-9939

Mailing address

PO Box 306393
Nashville, TN 37230-6393
Phone (615) 373-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210607000425 TN Practitioner - Physical Therapist in Private Practice 5496155889 Reassigns benefits to 2 organizations
I20240418004000 MS Practitioner - Physical Therapist in Private Practice 5496155889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exceed Physical Therapy, LLCGroup PAC ID 8123378338, 72 clinicians

Practice addresses (Care Compare)

12261 Hwy 49
Suite 1
Gulfport, MS 39503-2976
Phone (228) 265-7185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6991MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Exceed of Ms, LLC Physical Therapist CurrentSince Sep 17, 2023 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince May 10, 2021 Accepting new patients
Agilitas USA Inc CurrentSince May 10, 2021 Accepting new patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Aug 25, 2022 Accepting new patients
Agilitas USA Inc Physical Therapist Current Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

12261 Highway 49
Ste 1
Gulfport, MS 39503
Phone (228) 265-7185

5226 Airline Rd
Ste 131
Arlington, TN 38002
Phone (901) 441-7997

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

1000 Pickwick St
Savannah, TN 38372
Phone (731) 984-6202

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1447865985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5226 AIRLINE RD STE 131",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380029939",
            "telephone_number": "901-441-7997",
            "fax_number": "901-881-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYROSDICK",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-11",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "6991",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.