Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Collin Robert Wigely, DPT

Individual provider Physical Therapist · NPI 1447974126

Collin Robert Wigely, DPT is a Physical Therapist in Private Practice in Costa Mesa, California. Qualified in 2022, 4 years ago. Practices with Prosport Physical Therapy Professionals Inc, a 94-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2022
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1520 Nutmeg Pl Ste 111
Costa Mesa, CA 92626-2557
Phone: (714) 979-3500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 302960 (CA)
Physical Therapist Taxonomy 225100000X

Record details

NPI number1447974126
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 27, 2022
Last updated in NPPESDecember 27, 2023
Certification dateDecember 27, 2023
Mailing address1520 Nutmeg Pl Ste 111, Costa Mesa, CA 92626-2557

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Prosport Physical Therapy Professionals Inc — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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