NPIMap

Organization Active NPI

Wyoming Physical Therapy PC

  • Specialist
  • Cheyenne, WY
National Provider Identifier
1689226524
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WYOMING PHYSICAL THERAPY PC
Practice address
1620 E Pershing Blvd
Cheyenne, WY 82001-3238
Phone
(307) 772-0955
Fax
(307) 772-0953
NPI assigned
Jul 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Douglas K. Wilson
Title
Delegated Official
Phone
(307) 772-0955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1620 E Pershing Blvd
Cheyenne, WY 82001-3238

Mailing address

1217 S Greeley Hwy Ste a
Cheyenne, WY 82007-3063
Phone (307) 772-0955

Other names 1

  • FYZICAL Therapy and Balance Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brookside Physical Therapy14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1620 E Pershing Blvd
Cheyenne, WY 82001
Phone (307) 772-0955

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1689226524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 S GREELEY HWY STE A",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820073063",
            "telephone_number": "307-772-0955",
            "fax_number": "307-772-0953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E PERSHING BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013238",
            "telephone_number": "307-772-0955",
            "fax_number": "307-772-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "307-772-0955"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Therapy and Balance Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FYZICAL Therapy and Balance Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.