Individual provider Active NPI

Wendy Neesmith, PHYSICAL THERAPIST

  • Physical Therapist
  • Vidalia, GA
National Provider Identifier
1891915534
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003713 Issued in GA
Practice address
1703 Meadows LN
Vidalia, GA 30474-8915
Phone
(912) 537-8921
Fax
(912) 538-5341
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 003713 GA Primary

Addresses

Primary practice location

1703 Meadows LN
Vidalia, GA 30474-8915

Mailing address

1353 Harden Chapel Rd
Lyons, GA 30436-4948
Phone (912) 526-8249

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

LicenseStateTypeSpecialty
003713GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891915534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 HARDEN CHAPEL RD",
            "city": "LYONS",
            "state": "GA",
            "postal_code": "304364948",
            "telephone_number": "912-526-8249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 MEADOWS LN",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748915",
            "telephone_number": "912-537-8921",
            "fax_number": "912-538-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEESMITH",
        "first_name": "WENDY",
        "name_prefix": "Miss",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "003713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.