Individual provider Active NPI

Tobin P Wingard, PT

  • Physical Therapist
  • Bloomington, IN
National Provider Identifier
1649454513
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05005551A Issued in IN
Practice address
2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone
(812) 353-3343
Fax
(812) 353-3346
NPI assigned
Dec 27, 2007
Last updated
Apr 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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 05005551A IN Primary

Addresses

Primary practice location

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368

Mailing address

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone (812) 353-3343

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180508002165 IN Practitioner - Physical Therapist in Private Practice 1850655382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Saint Louis University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wingard Wellness and Therapy ServicesGroup PAC ID 4880931864, 3 clinicians

Practice addresses (Care Compare)

434 S Walnut St
Bloomington, IN 47401-4603
Phone (812) 322-1840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wingard Wellness & Therapy Services CurrentSince Jan 14, 2019 Accepting new patients
Iu Health Medical Group, LLC Past Accepting new patients

Locations

434 S Walnut St
Bloomington, IN 47401
Phone (812) 322-1840

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1649454513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-353-3343",
            "fax_number": "812-353-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-353-3343",
            "fax_number": "812-353-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGARD",
        "first_name": "TOBIN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-27",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05005551A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.