Douglas Brian Wiley Jr., P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2014016140 Issued in MO

Practice address

333 S Kirkwood Rd
Suite 201
Kirkwood, MO 63122-6161

Phone

(314) 909-4848

Fax

(314) 909-4824

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Premiere Physical Therapy & Sport Rehabilitation

  • Physical Therapist
  • Springfield, IL
  • NPI 1477660629
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401408000000",
    "number": "1992812879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14450 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S KIRKWOOD RD",
            "address_2": "SUITE 201",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226161",
            "telephone_number": "314-909-4848",
            "fax_number": "314-909-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "DOUGLAS",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2014-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.013844",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2014016140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Lee Welkener, PT
• Alexander Walter Werner
• West County Pulmonary Associates
• West County Vision Center LLC
• Emily Katherine Whitlock
• William E Pearson, LTD
• Williams Medical Group, P.C.
• Cathy Ann Williams, MSW,LCSW,CEAP
• Kimberly Williamson
• Elizabeth Grace Wilson, OTR/L

• Physical Therapist in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2014; 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.