Active NPI
Derrick A. Wolk, MPT
- Physical Therapist
- Farmington, MO
National Provider Identifier
1760628960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2008032045
- Practice address
- 109 Vierse Dr
Farmington, MO 63640-1323 - Phone
- (573) 756-2937
- Fax
- (573) 756-2939
- NPI assigned
- Dec 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2008032045 | MO | Primary |
Addresses
Primary practice location
109 Vierse Dr
Farmington, MO 63640-1323
Mailing address
1155 Hazel LN
Farmington, MO 63640-1920
Phone (573) 756-2937
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1195 Hazel LN
Farmington, MO 63640-1920
Phone (573) 756-2937
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008032045 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Solutions, LLC | Physical Therapist | Past | Accepting new patients |
Interoperability endpoints
- derrick.wolk.p2@direct.athleticoltd.nextgenshare.com
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.
-
- Physical Therapy Clinic/Center
- O Fallon, MO
- NPI 1003280421
-
- Physical Therapy Clinic/Center
- Washington, MO
- NPI 1679032700
-
- Physical Therapist
- Perryville, MO
- NPI 1790894962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564444800000",
"number": "1760628960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 HAZEL LN",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636401920",
"telephone_number": "573-756-2937",
"fax_number": "573-756-2939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 VIERSE DR",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636401323",
"telephone_number": "573-756-2937",
"fax_number": "573-756-2939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLK",
"first_name": "DERRICK",
"middle_name": "A.",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-18",
"last_updated": "2019-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2008032045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.