Active NPI
Ryan Wettstein, PT
- Physical Medicine & Rehabilitation Physician
- Draper, UT
National Provider Identifier
1932738309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- PTL.0013207
- Practice address
- 65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096 - Phone
- (385) 308-8034
- NPI assigned
- Apr 7, 2020
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 2019019016 | MO | |
| Physical Therapist | 225100000X | 40QA02161400 | NJ | |
| Physical Therapist | 225100000X | PT03646 | RI | |
| Physical Therapist | 225100000X | 5501302558 | MI | |
| Physical Medicine & Rehabilitation Physician | 208100000X | PTL.0013207 | CO | Primary |
Addresses
Primary practice location
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Mailing address
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone (385) 308-8034
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 |
|---|---|---|---|
| PTL.0013207 | CO | MD | Physical Medicine & Rehabilitation Physician |
| 2019019016 | MO | MD | Physical Medicine & Rehabilitation Physician |
| 5501302558 | MI | MD | Physical Therapist |
| 40QA02161400 | NJ | MD | Physical Therapist |
| PT03646 | RI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1932738309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 E WADSWORTH PARK DR STE 230",
"city": "DRAPER",
"state": "UT",
"postal_code": "840208096",
"telephone_number": "385-308-8034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 E WADSWORTH PARK DR STE 230",
"city": "DRAPER",
"state": "UT",
"postal_code": "840208096",
"telephone_number": "385-308-8034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETTSTEIN",
"first_name": "RYAN",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-07",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MO",
"license": "2019019016",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA02161400",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "RI",
"license": "PT03646",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501302558",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "CO",
"license": "PTL.0013207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.