Individual provider Active NPI

Robert Lee Wymbs

  • Physical Therapy Assistant
  • Augusta, GA
National Provider Identifier
1932963071
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA000674 Issued in GA
Practice address
1355 Independence Dr
Augusta, GA 30901-1037
Phone
(706) 798-1430
NPI assigned
Feb 8, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA000674 GA Primary

Addresses

Primary practice location

1355 Independence Dr
Augusta, GA 30901-1037

Mailing address

PO Box 12683
Augusta, GA 30914-0683
Phone (706) 294-7665

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
PTA000674GAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1932963071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12683",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309140683",
            "telephone_number": "706-294-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 INDEPENDENCE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309011037",
            "telephone_number": "706-798-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMBS",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA000674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.