NPI age
9 years
Enumerated 2016-09-19
● Active
Type 1 · Individual
Kendall E Wilde, DPT
Wilde is 1 of 89 physical therapist providers in Kennesaw and 1 of 7225 in Georgia.
Primary specialty
Physical Therapist
Plus 1 subspecialty
Licensed in
GA, AZ
2 states
Status
Active
No deactivations on record
Last NPPES update
2017-10-20
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 7225 active physical therapist providers in Georgia.
NPI age
9 years
≈ at median (10 yr)
State licenses
2 states
Top 89% — 10% of peers are multi-state
Subspecialties
0
18% of peers hold subspecialties
NPI lifetime · 2016 → 2026
2016-09Enumerated in NPPES
2016
2026
Where they practice
Practice location
1615 Ridenour Blvd Nw Ste 204
Kennesaw, GA 301524464
Mailing address
8541 E Anderson Dr Ste 100, Ste 100
Scottsdale, AZ 852555430
Specialties
-
Physical Therapist PrimaryPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | PT013169 | PHYSICAL THERAPY LICENSE |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.