Individual provider Active NPI

Ryan Wigley, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1861912750
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1290879 Issued in TX
Practice address
6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone
(817) 370-9891
NPI assigned
Jun 22, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 1290879 TX Primary

Addresses

Primary practice location

6037 Harris Pkwy
Fort Worth, TX 76132-4103

Mailing address

6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone (817) 370-9891

Other practice location 1

965 Hilltop Dr
Weatherford, TX 76086-5845
Phone (817) 594-7636

Other identifiers 2

IdentifierTypeStateIssuer
192079501MedicaidTX
752282621OtherTXTXID

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

State licenses

LicenseStateTypeSpecialty
1290879TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wedgwood Eyecare PC CurrentSince Jul 24, 2022 Accepting new patients
Kauai in-Home Therapy Plus Past Accepting new patients
Sportherapy LLC Physical Therapist PastSince Sep 17, 2019 Accepting new patients
Pure Motion Physical Therapy LLC Physical Therapist Past Accepting new patients
Sportherapy Southwest, PC Physical Therapist PastSince Jul 24, 2022 Accepting new patients

Locations

6037 Harris Pkwy
Fort Worth, TX 76132
Phone (817) 294-2800

Organizations & group practices 5

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861912750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324103",
            "telephone_number": "817-370-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6037 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324103",
            "telephone_number": "817-370-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "965 Hilltop Dr",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760865845",
            "country_code": "US",
            "telephone_number": "817-594-7636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGLEY",
        "first_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1290879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192079501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TXID",
            "identifier": "752282621",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.