Collin Robert Wigely, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

302960 Issued in CA

Practice address

1520 Nutmeg PL Ste 111
Costa Mesa, CA 92626-2557

Phone

(714) 979-3500

NPI assigned

Sep 27, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NM2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prosport Physical Therapy Professionals IncGroup PAC ID 0749510634, 93 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Prosport Physical Therapy Professionals Inc

  • Physical Therapy Clinic/Center
  • Costa Mesa, CA
  • NPI 1073170437

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Physical Therapy at Dawn, LLC

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1780695551
  Medicare reassignment NPD
• Prosport Physical Therapy Professionals Inc

  • Physical Therapist
  • Rancho Palos Verdes, CA
  • NPI 1487648341
  NPD
• Prosport Physical Therapy Professionals Inc

  • Specialist
  • Costa Mesa, CA
  • NPI 1649223694

  Physical Therapist

  NPD

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1447974126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 NUTMEG PL STE 111",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262557",
            "telephone_number": "714-979-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 NUTMEG PL STE 111",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262557",
            "telephone_number": "714-979-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGELY",
        "first_name": "COLLIN",
        "middle_name": "ROBERT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Taylor Whitman, AMFT
• Melissa Marie Whitsel
• Megan Wiechmann, PT
• Justin Wiekamp
• Sharon A Wierenga, MA LCPC, LPCC
• Megan Shikra Wiggins-Dye
• Linda Wilbanks
• Laurie R. Wilfert, MFT
• Lynnette Marie Wilhardt, LCSW
• Ryli Lauren Wilkerson I

• Physical Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.