Individual provider Active NPI

Eric Wiest, PT, DPT

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1730807173
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT39264 Issued in FL
Practice address
15751 San Carlos Blvd Ste 4
Fort Myers, FL 33908-3315
Phone
(239) 337-2739
NPI assigned
Aug 22, 2022
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 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 PT39264 FL Primary

Addresses

Primary practice location

15751 San Carlos Blvd Ste 4
Fort Myers, FL 33908-3315

Mailing address

15751 San Carlos Blvd Ste 4
Fort Myers, FL 33908-3315
Phone (239) 337-2739

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221019000103 FL Practitioner - Physical Therapist in Private Practice 8426424268 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT39264FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy of Southwest Florida, Inc. Physical Therapist CurrentSince Aug 16, 2022 Accepting new patients
Concepts in Rehab Inc PastSince Aug 16, 2022 Accepting new patients
Fyzbiz, LLC Physical Therapist Past Accepting new patients

Locations

900 SW Pine Island Rd
Ste 111113
Cape Coral, FL 33991
Phone (239) 573-8658

7990 Summerlin Lakes Dr
Ste 100
Fort Myers, FL 33907
Phone (239) 337-2739

15751 San Carlos Blvd
Ste 4
Fort Myers, FL 33908
Phone (239) 337-2739

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, 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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1730807173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15751 SAN CARLOS BLVD STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083315",
            "telephone_number": "239-337-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15751 SAN CARLOS BLVD STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083315",
            "telephone_number": "239-337-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEST",
        "first_name": "ERIC",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT39264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.