Individual provider Active NPI

Christopher Dende Wanyo

  • Physical Therapist
  • Lancaster, PA
National Provider Identifier
1053869099
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT025588 Issued in PA
Practice address
170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone
(717) 299-4871
NPI assigned
Sep 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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 PT025588 PA Primary

Addresses

Primary practice location

170 N Pointe Blvd
Lancaster, PA 17601-4132

Mailing address

430 Innovation Dr
Blairsville, PA 15717-8096
Phone (724) 343-4060

Other practice location 1

2913 Spooky Nook Rd Ste 100
Manheim, PA 17545-9149
Phone (717) 299-4871

Other practice location 2

212 Willow Valley Lakes Dr Ste 201
Willow Street, PA 17584-9668
Phone (717) 299-4871

Other practice location 3

1701 Cornwall Rd Ste 100
Lebanon, PA 17042-7480
Phone (717) 299-4871

Other practice location 4

16515 Pottsville Pike
Suite B
Hamburg, PA 19526-8182
Phone (484) 660-3139

Other identifiers 1

IdentifierTypeStateIssuer
1019541330001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170810002479 PA Practitioner - Physical Therapist in Private Practice 1557632411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Assoc of Lancaster LTDGroup PAC ID 8527041987, 81 clinicians

Practice addresses (Care Compare)

170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone (717) 299-4871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Dec 14, 2020 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Dec 14, 2020 Accepting new patients
Orthopedic Assoc of Lancaster LTD CurrentSince Oct 10, 2022 Accepting new patients
Orthopedic Assoc of Lancaster LTD CurrentSince Oct 10, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

170 N Pointe Blvd
Lancaster, PA 17601

2125 Noll Dr
Ste 100
Lancaster, PA 17603
Phone (717) 291-9920

1701 Cornwall Rd
Ste 100
Lebanon, PA 17042
Phone (717) 272-2919

2913 Spooky Nook Rd
Ste 100
Manheim, PA 17545

212 Willow Valley Lakes Dr
Ste 201
Willow Street, PA 17584

Organizations & group practices 5

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": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1053869099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 INNOVATION DR",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157178096",
            "telephone_number": "724-343-4060",
            "fax_number": "724-343-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 N POINTE BLVD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014132",
            "telephone_number": "717-299-4871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2913 Spooky Nook Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Manheim",
            "state": "PA",
            "postal_code": "175459149",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 Willow Valley Lakes Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Willow Street",
            "state": "PA",
            "postal_code": "175849668",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Cornwall Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170427480",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16515 Pottsville Pike",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Hamburg",
            "state": "PA",
            "postal_code": "195268182",
            "country_code": "US",
            "telephone_number": "484-660-3139",
            "fax_number": "484-660-3373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANYO",
        "first_name": "CHRISTOPHER",
        "middle_name": "DENDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-20",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019541330001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.