NPIMap

Individual provider Active NPI

Dylan Wile

  • Physical Therapist
  • Oregon City, OR
National Provider Identifier
1528625621
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
63260 Issued in OR
Practice address
19721 Or 213
Oregon City, OR 97045
Phone
(503) 305-8455
NPI assigned
May 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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 63260 OR Primary

Addresses

Primary practice location

19721 Or 213
Oregon City, OR 97045

Mailing address

12660 SE Shell LN
Milwaukie, OR 97222-8806
Phone (541) 505-0120

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
63260ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grapevine Womens Health and Gynecology, LLC PastSince Sep 3, 2013 Accepting new patients
Active Edge Physical Therapy, LLC Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7230/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1528625621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 SE SHELL LN",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972228806",
            "telephone_number": "541-505-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19721 OR 213",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "97045",
            "telephone_number": "503-305-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILE",
        "first_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.