Active NPI
Jennifer Joan Wiley, M.P.T.
- Physical Therapist
- Fort Collins, CO
National Provider Identifier
1982780342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5202
- Practice address
- 3744 S Timberline Rd
Suite 103
Fort Collins, CO 80525-4333 - Phone
- (970) 204-4263
- NPI assigned
- Oct 28, 2006
- Sex
- Female
- 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 | 5202 | CO | Primary |
Addresses
Primary practice location
3744 S Timberline Rd
Suite 103
Fort Collins, CO 80525-4333
Mailing address
3744 S Timberline Rd
Suite 103
Fort Collins, CO 80525-4333
Phone (970) 204-4263
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71489738 | Medicaid | CO |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5202 | CO | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204502400000",
"number": "1982780342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3744 S TIMBERLINE RD",
"address_2": "SUITE 103",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805254333",
"telephone_number": "970-204-4263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3744 S TIMBERLINE RD",
"address_2": "SUITE 103",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805254333",
"telephone_number": "970-204-4263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "JENNIFER",
"middle_name": "JOAN",
"credential": "M.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-28",
"last_updated": "2008-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "5202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71489738",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.