Individual provider Active NPI

Daniel Frank Wight Jr., MPT

  • Physical Therapist
  • Livonia, MI
National Provider Identifier
1831240613
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010536 Issued in MI
Practice address
29528 6 Mile Rd
Livonia, MI 48152-3671
Phone
(734) 422-0802
Fax
(734) 422-0873
NPI assigned
Jan 16, 2007
Last updated
Feb 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501010536 MI Primary

Addresses

Primary practice location

29528 6 Mile Rd
Livonia, MI 48152-3671

Mailing address

29528 6 Mile Rd
Livonia, MI 48152-3671
Phone (734) 422-0802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051205000580 MI Practitioner - Physical Therapist in Private Practice 6204856313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Physical Therapy Specialists Limited Partnership Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1831240613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29528 6 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523671",
            "telephone_number": "734-422-0802",
            "fax_number": "734-422-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29528 6 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523671",
            "telephone_number": "734-422-0802",
            "fax_number": "734-422-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGHT",
        "first_name": "DANIEL",
        "middle_name": "FRANK",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.