Individual provider Active NPI

Emily Repanich Wegmann, P.T.

  • Orthopedic Physical Therapist
  • Raleigh, NC
National Provider Identifier
1679572408
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
11677 Issued in NC
Practice address
3214 Charles B Root Wynd
Ste 101
Raleigh, NC 27612-5440
Phone
(919) 571-9912
Fax
(855) 291-6382
NPI assigned
Jul 14, 2005
Last updated
Apr 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT016934 PA
Orthopedic Physical Therapist 2251X0800X 11677 NC Primary

Addresses

Primary practice location

3214 Charles B Root Wynd
Ste 101
Raleigh, NC 27612-5440

Mailing address

3214 Charles B Root Wynd
Ste 101
Raleigh, NC 27612-5440
Phone (919) 571-9912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11677NCMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Pelvic Health Center, Inc. Physical Therapist CurrentSince Nov 18, 2011 Accepting new patients
Sports & More Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

3214 Charles B Root Wynd
#1
Raleigh, NC 27612
Phone (919) 571-9912

3214 Charles B Root Wynd
Ste 101
Raleigh, NC 27612
Phone (919) 571-9912

Organizations & group practices 2

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1679572408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 CHARLES B ROOT WYND",
            "address_2": "STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125440",
            "telephone_number": "919-571-9912",
            "fax_number": "855-291-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 CHARLES B ROOT WYND",
            "address_2": "STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125440",
            "telephone_number": "919-571-9912",
            "fax_number": "855-291-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGMANN",
        "first_name": "EMILY",
        "middle_name": "REPANICH",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016934",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "11677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.