Active NPI
John Brace Wynkoop, DPT, PT
- Physical Therapist
- Mesa, AZ
National Provider Identifier
1821980475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-034235
- Practice address
- 6553 E Baywood Ave Ste 209
Mesa, AZ 85206-1754 - Phone
- (460) 048-0712
- NPI assigned
- Jul 17, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | LPT-034235 | AZ | Primary |
Addresses
Primary practice location
6553 E Baywood Ave Ste 209
Mesa, AZ 85206-1754
Mailing address
6553 E Baywood Ave Ste 209
Mesa, AZ 85206-1754
Phone (480) 712-4600
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 |
|---|---|---|---|
| LPT-034235 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1821980475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6553 E BAYWOOD AVE STE 209",
"city": "MESA",
"state": "AZ",
"postal_code": "852061754",
"telephone_number": "480-712-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6553 E BAYWOOD AVE STE 209",
"city": "MESA",
"state": "AZ",
"postal_code": "852061754",
"telephone_number": "460-048-0712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNKOOP",
"first_name": "JOHN",
"middle_name": "BRACE",
"credential": "DPT, PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-17",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-034235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.