Active NPI
Keith Wayne Wrich, DPT
- Physical Therapist
- Hampton, IA
National Provider Identifier
1902240260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004975
- Practice address
- 1720 Central Ave E
Hampton, IA 50441-1869 - Phone
- (641) 456-5034
- Fax
- (641) 456-5801
- NPI assigned
- Apr 17, 2013
- Last updated
- Apr 17, 2013
- Sex
- Male
- Sole proprietor
- No
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 | 004975 | IA | Primary |
Addresses
Primary practice location
1720 Central Ave E
Hampton, IA 50441-1869
Mailing address
PO Box 461
Nevada, IA 50201-0461
Phone (515) 382-3366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004975 | Other | IA | PT LICENSE |
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 |
|---|---|---|---|
| 004975 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366156800000",
"number": "1902240260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 461",
"city": "NEVADA",
"state": "IA",
"postal_code": "502010461",
"telephone_number": "515-382-3366",
"fax_number": "515-382-1576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 CENTRAL AVE E",
"city": "HAMPTON",
"state": "IA",
"postal_code": "504411869",
"telephone_number": "641-456-5034",
"fax_number": "641-456-5801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRICH",
"first_name": "KEITH",
"middle_name": "WAYNE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-17",
"last_updated": "2013-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "004975",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "004975",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hampton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.