Jennifer L Wichterman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7865 Issued in TN

Practice address

99-128 Aiea Heights Drive
Suite 114
Aiea, HI 96701-3968

Phone

(808) 487-0487

Fax

(808) 486-8674

NPI assigned

Nov 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437177600000",
    "number": "1558541391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 KAMOKILA BLVD",
            "address_2": "SUITE 114",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072097",
            "telephone_number": "808-674-0500",
            "fax_number": "808-674-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-128 AIEA HEIGHTS DRIVE",
            "address_2": "SUITE 114",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013968",
            "telephone_number": "808-487-0487",
            "fax_number": "808-486-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHTERMAN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-09",
        "last_updated": "2015-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "7865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446631",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Aiea, HI
• Providers in Aiea, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; 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.