Individual provider Active NPI

Ellie Wolfenden

  • Physical Therapist
  • Lewes, DE
National Provider Identifier
1043977564
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0014484 Issued in DE
Practice address
701 Savannah Rd
Lewes, DE 19958-1550
Phone
(302) 644-2530
NPI assigned
Nov 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J1-0014484 DE Primary

Addresses

Primary practice location

701 Savannah Rd
Lewes, DE 19958-1550

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220901003690 DE Practitioner - Physical Therapist in Private Practice 1658755095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Therapy Services LLCGroup PAC ID 0749283083, 99 clinicians

Practice addresses (Care Compare)

701 Savannah Rd
Suite A1
Lewes, DE 19958-1550
Phone (302) 644-2530

Merit-based Incentive Payment System (MIPS)

Final score
87.27 of 100Reported as group
Quality
85
Promoting interoperability
99
Improvement activities
40
Cost
73.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Therapy Services, LLC Physical Therapist CurrentSince May 25, 2022 Accepting new patients
Dynamic Therapy Services LLC Physical Therapist CurrentSince May 25, 2022 Accepting new patients

Locations

701 Savannah Rd
Ste A1
Lewes, DE 19958
Phone (302) 644-2530

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1043977564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SAVANNAH RD",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199581550",
            "telephone_number": "302-644-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFENDEN",
        "first_name": "ELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0014484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.