Individual provider Active NPI

Larry Wessel, PTA

  • Contractor
  • Largo, FL
National Provider Identifier
1992075832
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
PTA193 Issued in FL
Practice address
12883 109TH St
Largo, FL 33778-2117
Phone
(727) 244-0369
NPI assigned
Jan 10, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X PTA193 FL Primary

Addresses

Primary practice location

12883 109TH St
Largo, FL 33778-2117

Mailing address

12883 109TH St
Largo, FL 33778-2117

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
PTA193FLMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1992075832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12883 109TH ST",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12883 109TH ST",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782117",
            "telephone_number": "727-244-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSEL",
        "first_name": "LARRY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "PTA193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.