Wendy Jane Carranco, PT

Key facts

NPI

1568683068

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

PT14738 (FL)

Practice address

1572 Dena Cir
Wauchula, FL 33873-8410

Phone

(863) 781-2108

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 18, 2016.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1568683068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1572 DENA CIR",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338738410",
            "telephone_number": "863-781-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1572 DENA CIR",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338738410",
            "telephone_number": "863-781-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRANCO",
        "first_name": "WENDY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14738",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "52071",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL PT LICENSE",
            "identifier": "52071",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT14738",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Wauchula, FL · Physical Therapist in Florida