Active NPI
Stephanie Wight, PT, DPT
- Physical Therapist
- Fairbanks, AK
National Provider Identifier
1801276712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 121582
- Practice address
- 3065 College Rd
Fairbanks, AK 99709-3702 - Phone
- (907) 374-1686
- NPI assigned
- Jun 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | 20561 | MA | |
| Physical Therapist | 225100000X | 121582 | AK | Primary |
Addresses
Primary practice location
3065 College Rd
Fairbanks, AK 99709-3702
Mailing address
3065 College Rd
Fairbanks, AK 99709-3702
Phone (907) 374-1686
Other practice location 1
555 Amory St
Jamaica Plain, MA 02130-2652
Phone (617) 383-6522 ext. 232
Other practice location 2
837 Chief Eddie Hoffman Highway
Attn BH Fit Program
Bethel, AK 99559-0528
Phone (907) 543-3690
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1002573 | Medicaid | AK |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121582 | AK | MD | Physical Therapist |
| 20561 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1801276712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3065 COLLEGE RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093702",
"telephone_number": "907-374-1686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3065 COLLEGE RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093702",
"telephone_number": "907-374-1686"
}
],
"practiceLocations": [
{
"address_1": "555 Amory St",
"address_purpose": "LOCATION",
"city": "Jamaica Plain",
"state": "MA",
"postal_code": "021302652",
"country_code": "US",
"telephone_number": "617-383-6522 x232",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "837 Chief Eddie Hoffman Highway",
"address_2": "ATTN BH FIT PROGRAM",
"address_purpose": "LOCATION",
"city": "Bethel",
"state": "AK",
"postal_code": "995590528",
"country_code": "US",
"telephone_number": "907-543-3690",
"fax_number": "907-543-1276",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIGHT",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-05",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "20561",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AK",
"license": "121582",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1002573",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.