Individual provider Active NPI

Ian Michael Wright, PT

  • Physical Therapist
  • Jbphh, HI
National Provider Identifier
1477043537
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
755 Scott Cir
Jbphh, HI 96853-5399
Phone
(808) 448-6137
NPI assigned
May 15, 2018
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1319922 TX
Physical Therapist 225100000X Primary

Addresses

Primary practice location

755 Scott Cir
Jbphh, HI 96853-5399

Mailing address

755 Scott Cir
Jbphh, HI 96853-5399
Phone (808) 448-6137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1319922TXMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy and Sports Medicine, Inc. CurrentSince Jul 1, 2018 Accepting new patients

Locations

141 Atrium Way
Columbia, SC 29223
Phone (803) 788-8484

75 W Wesmark Blvd
Sumter, SC 29150
Phone (800) 456-5857

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1477043537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "IAN",
        "middle_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-15",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1319922",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbphh, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.