Russell Alan Wiglesworth, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-00821 Issued in KS

Practice address

15455 S Rogers Rd
Olathe, KS 66062-3497

Phone

(913) 254-0568

Fax

(913) 254-0854

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Exercise Therapy Consultants, Inc.

  • Physical Therapist
  • Belton, MO
  • NPI 1962414250
  NPD (past)
• Mid America Balance Institute of Cass County Missouri

  • Respiratory/Developmental/Rehabilitative Specialist/Technologist
  • Belton, MO
  • NPI 1902050511
  NPD (past)
• Spine & Extremity Rehabilitation Center of Kansas City North Inc

  • Physical Therapist
  • Riverside, MO
  • NPI 1962450569
  NPD (past)
• Spine and Extremity Rehabilitation Center of Raytown Inc

  • Physical Therapist
  • Raytown, MO
  • NPI 1568410165
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1619921137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219297",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641219297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15455 S ROGERS RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660623497",
            "telephone_number": "913-254-0568",
            "fax_number": "913-254-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGLESWORTH",
        "first_name": "RUSSELL",
        "middle_name": "ALAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "R0956",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-00821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Wickliffe
• John Wiebelhaus, M.D.
• Stacie Wiechman
• Elizabeth Wieczorek, LPC
• Anne Kathleen Wietharn, MA, CCC-SLP
• Amy D Wilcox, M.A. BCBA
• Howard Lea Wilcox Jr., MD
• Karl Eric Wilen, D.C.
• Alison Wiley
• Jessica N Wilhelmi, LMFT

• Physical Therapist in Olathe, KS
• Providers in Olathe, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.