Douglas Dean Wisdom, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT10870 Issued in CA

Practice address

426 N Imperial Ave
El Centro, CA 92243-2329

Phone

(760) 592-8148

NPI assigned

Sep 30, 2008

Last updated

Oct 7, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Loma Linda University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Farid Zia Physical Therapist a Professional CorpGroup PAC ID 5193613289, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Farid Zia Physical Therapist a Professional Corp

  • Physical Therapist
  • El Centro, CA
  • NPI 1922146109
  Medicare reassignment Care Compare group NPD
• MDRS Spine & Sport, Inc

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1952394603
  Medicare reassignment
• Wisdom Physical Therapy, Inc.

  • Physical Therapist
  • El Centro, CA
  • NPI 1780073718
  Authorized official Same address or phone

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1912157637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 N IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922432329",
            "telephone_number": "760-592-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 N IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922432329",
            "telephone_number": "760-592-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "DOUGLAS",
        "middle_name": "DEAN",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT10870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tenisha Maritza Williams
• Tina Annette Williams, LMFT 135280
• Arlene Wimer-Silva
• Nayram Guadalupe Winkler
• Wisdom Physical Therapy, Inc.
• Without Limits ABA Therapy Inc
• Rosemonde Woel, M.D.
• Patrick Wolcott, MD
• Womanhaven
• Womanhaven, Inc. (Center for Family Solutions)

• Physical Therapist in El Centro, CA
• Providers in El Centro, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.