Deanna C Wilken, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

116407 Issued in MO

Practice address

1330 YMCA Dr
Suite 1200
Festus, MO 63028-2661

Phone

(636) 931-7600

Fax

(636) 931-8808

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jefferson County Rehabilitation

  • Physical Therapy Clinic/Center
  • Festus, MO
  • NPI 1154445369
  NPD (past)

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1760634901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 YMCA DR",
            "address_2": "SUITE 1200",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282661",
            "telephone_number": "636-931-7600",
            "fax_number": "636-931-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 YMCA DR",
            "address_2": "SUITE 1200",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282661",
            "telephone_number": "636-931-7600",
            "fax_number": "636-931-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKEN",
        "first_name": "DEANNA",
        "middle_name": "C",
        "credential": "P.T.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "116407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Whitwell
• Carrie Wickerham
• Stephanie M Wideman, MSW, LCSW
• Wild Roots Birth Collective LLC
• Shelby Wilfong
• Kaitlyn Lee Wilkinson, OTR/L
• Caree Williams
• Eric Williams
• Mary Ann Williams
• Renee Williams

• Physical Therapy Assistant in Festus, MO
• Providers in Festus, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.