Individual provider Active NPI

Joshua Wilkes, MPT

  • Specialist
  • Clarks Summit, PA
National Provider Identifier
1992055446
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT022256 Issued in PA
Practice address
718 S. State Street
Clarks Summit, PA 18411-2607
Phone
(570) 586-2222
NPI assigned
Sep 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT022256 PA Primary

Addresses

Primary practice location

718 S. State Street
Clarks Summit, PA 18411-2607

Mailing address

718 S. State Street
Clarks Summit, PA 18411-2607
Phone (570) 586-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421001529 PA Practitioner - Physical Therapist in Private Practice 1456679596 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT022256PAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Physical Therapy of Pennsylvania, LLC CurrentSince Jun 1, 2017 Accepting new patients
Dynamic Therapy Services, LLC Past Accepting new patients

Locations

824 McAlpine St
Ste 5
Avoca, PA 18641
Phone (570) 471-7662

63 Dallas Village Shopping Ctr
Dallas, PA 18612
Phone (570) 310-1881

328 Market St
Lewisburg, PA 17837
Phone (570) 768-4922

417 Grow Ave
Montrose, PA 18801
Phone (570) 278-1101

655 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2142

24569 Route 6
#C
Towanda, PA 18848
Phone (570) 265-1111

130 W Main St
Ste 100B
Trappe, PA 19426
Phone (484) 471-6850

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1992055446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 S. STATE STREET",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184112607",
            "telephone_number": "570-586-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 S. STATE STREET",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184112607",
            "telephone_number": "570-586-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "JOSHUA",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "PT022256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.