Sutherland Wyatt, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-7263 Issued in ID

Practice address

754 N College Rd Ste D
Twin Falls, ID 83301-5822

Phone

(208) 734-5313

NPI assigned

May 17, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Physical Rehabilitation, LLCGroup PAC ID 6002882164, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Center for Physical Rehabilitation, LLC

  • Physical Therapist
  • Twin Falls, ID
  • NPI 1427029610
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1649844358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 JEROME ST E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016269",
            "telephone_number": "530-514-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 N COLLEGE RD STE D",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015822",
            "telephone_number": "208-734-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "SUTHERLAND",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-7263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427029610",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "Y",
            "affiliationName": "CENTER FOR PHYSICAL REHABILITATION, LLC",
            "address_1": "754 N College Rd Ste D",
            "city": "Twin Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "833015822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark Wayne Wright, MD
• Wayne Wright, M.D.
• Michael Kenneth Wucinich, PA-C
• Clark Joseph Wyatt, NP-C
• Katie Marie Wyatt, NP-C
• Nickolas David Wynn, PHARMD
• Xavier Charter School District 462
• Lin Xia
• Deborah Jan Yingst, PT
• Benjamin A Yoder, DPT

• Physical Therapist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.