Active NPI
Gunnar Wyatt
- Physical Therapist
- Westmont, IL
National Provider Identifier
1790341121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 600 Oakmont LN Ste 600C
Westmont, IL 60559-5548 - Phone
- (630) 575-6250
- NPI assigned
- May 10, 2019
- Last updated
- Mar 17, 2021
- 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 | Primary |
Addresses
Primary practice location
600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Mailing address
3038 Redbud Cir
Ames, IA 50014-4518
Phone (515) 708-4940
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home Team Wellness and Recovery, LLC | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Ames, IA
- NPI 1700412848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1790341121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3038 REDBUD CIR",
"city": "AMES",
"state": "IA",
"postal_code": "500144518",
"telephone_number": "515-708-4940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 OAKMONT LN STE 600C",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605595548",
"telephone_number": "630-575-6250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "GUNNAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-10",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westmont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.