Organization Active NPI

Wingard Wellness & Therapy Services

  • Geriatric Physical Therapist
  • Bloomington, IN
National Provider Identifier
1972076198
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
Legal business name
WINGARD WELLNESS & THERAPY SERVICES
Practice address
434 S Walnut St
Bloomington, IN 47401-4603
Phone
(812) 322-1840
Fax
(812) 316-9798
NPI assigned
Jan 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Authorized official

Name
Dr. Tobin Paul Wingard, PT, DPT, GCS, FDNNPI 1649454513
Title
Doctor of Physical Therapy
Phone
(812) 322-1840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251G0304X Primary

Addresses

Primary practice location

434 S Walnut St
Bloomington, IN 47401-4603

Mailing address

8463 S Marcy CT
Bloomington, IN 47401-7208
Phone (812) 322-1840

Other practice location 1

639 S Walker St Ste A
Bloomington, IN 47403-2124
Phone (812) 322-1840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190129002739 IN Part B Supplier - Clinic/Group Practice 4880931864 Receives reassigned benefits from 3 practitioners
Practice locations: Bloomington, IN

National Provider Directory

National Provider Directory

Locations

434 S Walnut St
Bloomington, IN 47401
Phone (812) 322-1840

639 S Walker St
Ste A
Bloomington, IN 47403
Phone (317) 455-1064

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1972076198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8463 S MARCY CT",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474017208",
            "telephone_number": "812-322-1840",
            "fax_number": "812-316-9897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 S WALNUT ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474014603",
            "telephone_number": "812-322-1840",
            "fax_number": "812-316-9798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "639 S Walker St Ste A",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032124",
            "country_code": "US",
            "telephone_number": "812-322-1840",
            "fax_number": "812-316-9897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WINGARD WELLNESS & THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "WINGARD",
        "authorized_official_first_name": "TOBIN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "812-322-1840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, GCS, FDN"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.