Individual provider Active NPI

Kimberly Ann Wheeler, M.P.T.

  • Physical Therapist
  • Oaklyn, NJ
National Provider Identifier
1639129398
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01028500 Issued in NJ
Practice address
1103 White Horse Pike
Oaklyn, NJ 08107
Phone
(856) 858-9601
Fax
(856) 858-1363
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01028500 NJ Primary

Addresses

Primary practice location

1103 White Horse Pike
Oaklyn, NJ 08107

Mailing address

16 Washington St
Gibbsboro, NJ 08026-1440
Phone (856) 346-4088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150320001182 NJ Practitioner - Physical Therapist in Private Practice 5193042661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01028500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT Inc. Current Accepting new patients
Rehabclinics SPT Inc CurrentSince Apr 22, 2023 Accepting new patients
Rehabclinics SPT Inc Past Accepting new patients

Locations

2144 US Highway 130
Ste 12
Bordentown, NJ 08505
Phone (609) 324-9320

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1639129398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WASHINGTON ST",
            "city": "GIBBSBORO",
            "state": "NJ",
            "postal_code": "080261440",
            "telephone_number": "856-346-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WHITE HORSE PIKE",
            "city": "OAKLYN",
            "state": "NJ",
            "postal_code": "08107",
            "telephone_number": "856-858-9601",
            "fax_number": "856-858-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01028500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oaklyn, NJ

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.