Active NPI
Jason Wiley, PT
- Physical Therapist
- Detroit, MI
National Provider Identifier
1508106352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2839100298
- Practice address
- 15100 Gratiot Ave
Detroit, MI 48205-1302 - Phone
- (888) 433-2872
- NPI assigned
- Feb 15, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2839100298 | MI | Primary |
Addresses
Primary practice location
15100 Gratiot Ave
Detroit, MI 48205-1302
Mailing address
PO Box 1435
Warren, MI 48090-1435
Phone (888) 433-2872
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2839100298 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360886400000",
"number": "1508106352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1435",
"city": "WARREN",
"state": "MI",
"postal_code": "480901435",
"telephone_number": "888-433-2872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15100 GRATIOT AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482051302",
"telephone_number": "888-433-2872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "JASON",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-15",
"last_updated": "2013-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "2839100298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.