Korryn Wiese, P.T., C.M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

117905-2401 Issued in UT

Practice address

5856 Harrison Blvd
Suite a
South Ogden, UT 84403-4397

Phone

(801) 475-6415

Fax

(801) 475-6417

NPI assigned

Mar 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Body Tune Physical Therapy PCGroup PAC ID 5092723817, 2 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.

• Body Tune Physical Therapy PC

  • Physical Therapist
  • South Ogden, UT
  • NPI 1952522419
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187481600000",
    "number": "1528036878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5856 HARRISON BLVD",
            "address_2": "SUITE A",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034397",
            "telephone_number": "801-475-6415",
            "fax_number": "801-475-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5856 HARRISON BLVD",
            "address_2": "SUITE A",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034397",
            "telephone_number": "801-475-6415",
            "fax_number": "801-475-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "KORRYN",
        "credential": "P.T., C.M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-11",
        "last_updated": "2007-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "117905-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaydon Whitcomb, RBT
• Kevin Kyle White, CMHC
• Roy White, RPH
• Nickolas Whitesides
• Charlene Wichman
• Willard Z Maughan M.D. P.C.
• Sianeh Williams-Geddings, RBT
• Michael Williams, RBT
• Cameran Rachelle Wilson, FNP-C
• Makenzie Baird Womack

• Physical Therapist in South Ogden, UT
• Providers in South Ogden, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2007; 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.