Individual provider Active NPI

Wyatt Louis Kurzejeski, DPT

  • Physical Therapist
  • Washington, IA
National Provider Identifier
1477151306
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
105395 Issued in IA
Practice address
511 Highway 1 S
Washington, IA 52353-9782
Phone
(319) 653-5494
NPI assigned
Oct 13, 2020
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 105395 IA Primary

Addresses

Primary practice location

511 Highway 1 S
Washington, IA 52353-9782

Mailing address

511 Highway 1 S
Washington, IA 52353-9782
Phone (319) 653-5494

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
105395IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jet PT PC Physical Therapist CurrentSince Oct 21, 2020 Accepting new patients
Physical Therapy Services PC Physical Therapist PastSince Oct 1, 2020 Accepting new patients

Locations

1506 E Washington St
Washington, IA 52353
Phone (319) 653-5494

511 Highway 1 S
Washington, IA 52353
Phone (319) 653-5494

525 13th St
Ste 101
Wellman, IA 52356
Phone (319) 646-5381

Organizations & group practices 2

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": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1477151306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 HIGHWAY 1 S",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523539782",
            "telephone_number": "319-653-5494",
            "fax_number": "319-863-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 HIGHWAY 1 S",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523539782",
            "telephone_number": "319-653-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURZEJESKI",
        "first_name": "WYATT",
        "middle_name": "LOUIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-13",
        "last_updated": "2022-10-04",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "105395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.