Active NPI
Marilynn Patten Wyatt, PT
- Ergonomics Physical Therapist
- San Diego, CA
National Provider Identifier
1619168960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ergonomics Physical Therapist
- License
- 6688
- Practice address
- 34800 Bob Wilson Dr
Nmcsd
San Diego, CA 92134-1098 - Phone
- (619) 532-6459
- NPI assigned
- Aug 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ergonomics Physical Therapist | 2251E1200X | 6688 | CA | Primary |
| Clinical Electrophysiology Physical Therapist | 2251E1300X | EK 6 | CA | |
| Kinesiotherapist | 226300000X |
Addresses
Primary practice location
34800 Bob Wilson Dr
Nmcsd
San Diego, CA 92134-1098
Mailing address
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone (619) 532-6459
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| EK 6 | CA | MD | Clinical Electrophysiology Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424995200000",
"number": "1619168960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098",
"telephone_number": "619-532-6459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"address_2": "NMCSD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098",
"telephone_number": "619-532-6459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "MARILYNN",
"middle_name": "PATTEN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-01",
"last_updated": "2015-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "2251E1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Ergonomics",
"state": "CA",
"license": "6688",
"primary": true
},
{
"code": "2251E1300X",
"taxonomy_group": "",
"desc": "Physical Therapist, Electrophysiology, Clinical",
"state": "CA",
"license": "EK 6",
"primary": false
},
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.