Kyle Wimberley

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1309796 Issued in TX

Practice address

1316 S Highway 16
Fredericksburg, TX 78624-5058

Phone

(830) 997-2001

NPI assigned

Jun 28, 2021

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Revive Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Spicewood, TX
  • NPI 1942205679
  NPD (past)

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1528638061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MARY FRANCES DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780283440",
            "telephone_number": "210-548-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 S HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245058",
            "telephone_number": "830-997-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBERLEY",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1309796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roland Wilke, FNP-C
• Baileigh Williams, FNP-C
• Edward Joseph Williams
• Michael Ray Williams, D.O.
• Michelle Wilson, DPT
• Windcrest Opco LLC
• Lauren E Winn, LMT
• Julie Woerner, PT
• Women and Children First, PA
• Taylor Works, MD

• Physical Therapist in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.