Individual provider Active NPI

Wesley Wade Leonard

  • Physical Therapist
  • St Johns, FL
National Provider Identifier
1669123600
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
115 Bartram Oaks Walk
St Johns, FL 32259-3243
Phone
(904) 217-3107
NPI assigned
Jan 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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 Primary

Addresses

Primary practice location

115 Bartram Oaks Walk
St Johns, FL 32259-3243

Mailing address

121 Jardin de Mer PL
Jacksonville Beach, FL 32250-8609
Phone (239) 851-0085

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220225000850 FL Practitioner - Physical Therapist in Private Practice 2062806516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Solutions of Pensacola, LLCGroup PAC ID 7517102973, 32 clinicians

Practice addresses (Care Compare)

115 Bartram Oaks Walk
Suite 101
Saint Johns, FL 32259-3247
Phone (678) 459-3758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PT Solutions of Pensacola, LLC Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
PT Solutions of Pensacola LLC Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
Rehab Advantage Solutions, PLLC Physical Therapist CurrentSince Mar 14, 2024 Accepting new patients

Locations

8477 S Suncoast Blvd
Homosassa, FL 34446
Phone (800) 381-0822

250 Palm Coast Pkwy NE
Unit 209A
Palm Coast, FL 32137
Phone (386) 597-1927

5401 Corporate Woods Dr
Ste 300
Pensacola, FL 32504
Phone (850) 912-6840

236 Ponte Vedra Park Dr
Ste 300
Ponte Vedra Beach, FL 32082
Phone (904) 280-3440

115 Bartram Oaks Walk
Ste 101
St Johns, FL 32259
Phone (904) 217-3107

1100 Circle 75 Pkwy SE
Ste 1400
Atlanta, GA 30339
Phone (678) 403-3555

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": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1669123600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 JARDIN DE MER PL",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322508609",
            "telephone_number": "239-851-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BARTRAM OAKS WALK",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322593243",
            "telephone_number": "904-217-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "WESLEY",
        "middle_name": "WADE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.