NPIMap

Organization Active NPI

Momentum Physical Therapy

  • Physical Therapy Clinic/Center
  • Gillette, WY
National Provider Identifier
1841656196
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1565 Issued in WY
Legal business name
MOMENTUM PHYSICAL THERAPY
Practice address
305 E Lakeway Rd
Gillette, WY 82718-6301
Phone
(307) 696-6045
Fax
(307) 696-6046
NPI assigned
Dec 31, 2015
Last updated
Jun 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Authorized official

Name
Kayla Anne Williamsen, PTNPI 1740569185
Title
Owner/Physical Therapist
Phone
(307) 696-6045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1565 WY Primary

Addresses

Primary practice location

305 E Lakeway Rd
Gillette, WY 82718-6301

Mailing address

305 E Lakeway Rd
Gillette, WY 82718-6301
Phone (307) 696-6045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160308000372 WY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7214233873 Receives reassigned benefits from 6 practitioners
Practice locations: Gillette, WY
O20230714002619 WY DME Supplier - Independently-Practicing Physical Therapist 7214233873 Practice locations: Gillette, WY

National Provider Directory

National Provider Directory

Locations

305 E Lakeway Rd
Gillette, WY 82718
Phone (307) 696-6045

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1841656196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E LAKEWAY RD",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186301",
            "telephone_number": "307-696-6045",
            "fax_number": "307-696-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E LAKEWAY RD",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186301",
            "telephone_number": "307-696-6045",
            "fax_number": "307-696-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-31",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSEN",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "307-696-6045",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WY",
            "license": "1565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.