Kimberly Lynn Wiley, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A4935 Issued in MD

Practice address

710 Obrecht Rd
Sykesville, MD 21784-7650

Phone

(410) 804-4803

NPI assigned

Dec 27, 2018

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1790257962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 THORNBROOK RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421748",
            "telephone_number": "443-472-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 OBRECHT RD",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217847650",
            "telephone_number": "410-804-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Way Station, Inc.
• Stephen Weatherholt
• Michelle Ashby Webb, OTR/L
• Bruce C Wells, M.D.
• Wesley-Freedom Methodist Church
• Teena Wilkerson, MS, RD, LDN
• Desiree Dione Williams, D.C.
• Noah Daniel Williamson, DC
• Mary Nash Wilson, LMSW
• Sarah Wilson

• Physical Therapy Assistant in Sykesville, MD
• Providers in Sykesville, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.