WYATT JAMES KIPP (DPT) – Physical Therapist, NPI 1144951864

WYATT JAMES KIPP (DPT) is a healthcare provider. based in La vista, Nebraska. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 4332 (NE). The NPI Number for WYATT JAMES KIPP (DPT) is 1144951864

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
WYATT JAMES KIPP (DPT)
NPI
1144951864
Phone
(308) 655-0645
Address
11435 GERTRUDE CT APT 201
Enumeration Date
22 June 2022
Last Update Date
16 April 2026

Doctor Profile

Medical School Name
CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4022343333
Graduation Year
2022 (4 years ago)
PAC ID
0648702472
Group Practice PAC ID
2365758588
Professional Enrollment ID
I20241017001051
Address ID
NE680377025LO1268XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

841 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NE

Provider Addresses for WYATT JAMES KIPP (DPT)

  • 11435 GERTRUDE CT APT 201

    LA VISTA, NE 681284794

    Phone: (308) 655-0645

    Type: Mailing

  • 1702 HILLCREST DR

    BELLEVUE, NE 680053652

    Phone: (402) 291-8500

    Type: Location

  • 1268 E HENRY ST STE 1

    LOUISVILLE, NE 680377025

    Phone: (402) 234-3333

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241017001051IPhysical Therapist In Private PracticeNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68128)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365758588View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
Occupational Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE

Reviews

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Frequently asked questions

Can I cross-check WYATT JAMES KIPP (DPT) using NPI 1144951864?
NPI 1144951864 belongs to WYATT JAMES KIPP (DPT); compare other details if you need extra assurance.
Is WYATT JAMES KIPP (DPT) shown as active in public data?
Registry records indicate WYATT JAMES KIPP (DPT) maintains an active NPI.
What clinical focus is listed for WYATT JAMES KIPP (DPT)?
At a glance, WYATT JAMES KIPP (DPT) is tied to Physical Therapist. Clinical services aligned with this taxonomy classification.
Where in Nebraska is WYATT JAMES KIPP (DPT) registered?
Use La Vista, Nebraska as the headline location for WYATT JAMES KIPP (DPT) here.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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