Michael R Wimberly II, PT,MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT04879 Issued in LA

Practice address

107 Front St Ste 230
Vidalia, LA 71373-2836

Phone

(318) 336-2224

Fax

(318) 336-6068

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

J H Fairbanks, MD PLLCGroup PAC ID 2062504798, 2 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.

• J H Fairbanks MD PLLC

  • Orthopaedic Surgery Physician
  • Vidalia, LA
  • NPI 1336209550
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1700937950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 LINDBERG AVE",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204884",
            "telephone_number": "601-304-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 FRONT ST STE 230",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713732836",
            "telephone_number": "318-336-2224",
            "fax_number": "318-336-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBERLY",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_suffix": "II",
        "credential": "PT,MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "PT04879",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04220001",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2318781",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Williams
• Keymond Williams
• Mary Williams
• Stasha Willis
• Oneka Wilson, MHS
• Anna R Womack, DDS
• Kenneth Woo
• Erin Fournet Woodruff, DPT
• Angelica Francheska Woods

• Physical Therapist in Vidalia, LA
• Providers in Vidalia, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.