Jennifer Lynn Advent, D.P.T.
Individual provider Active NPI Physical Therapist · Gahanna, OH
NPI 1003069956 · NPPES record last updated Apr 19, 2010
Key facts
- NPI
- 1003069956
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 012274 (OH)
- Practice address
- 1045 Beecher Xing N
Suite C
Gahanna, OH 43230-4573 - Phone
- (614) 775-9618
- Fax
- (614) 775-9633
- NPI assigned
- Oct 23, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100419000200 | OH | Practitioner - Physical Therapist in Private Practice | 3779610068 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012274 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio Luna Care Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
Locations
4200 Regent St
Ste 200
Columbus, OH 43219
Phone (877) 581-2210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 012274 | OH | Yes |
Addresses
Primary practice location
1045 Beecher Xing N
Suite C
Gahanna, OH 43230-4573
Mailing address
1045 Beecher Xing N
Suite C
Gahanna, OH 43230-4573
Phone (614) 775-9618
Other names
- Jennifer Lynn Wade
Other providers in Gahanna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.