Individual provider Active NPI

Patricia Dawn Wittekind, PTA

  • Physical Therapy Assistant
  • Plymouth Meeting, PA
National Provider Identifier
1063656189
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TE1000515 Issued in PA
Practice address
2250 Hickory Rd Ste 240
Plymouth Meeting, PA 19462-2225
Phone
(610) 834-1122
Fax
(610) 684-4547
NPI assigned
Apr 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE1000515 PA Primary

Addresses

Primary practice location

2250 Hickory Rd Ste 240
Plymouth Meeting, PA 19462-2225

Mailing address

22 1/2 Pennsylvania Ave
Fairless Hills, PA 19030-1318
Phone (215) 736-3242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TE1000515PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1063656189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 1/2 PENNSYLVANIA AVE",
            "city": "FAIRLESS HILLS",
            "state": "PA",
            "postal_code": "190301318",
            "telephone_number": "215-736-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HICKORY RD STE 240",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622225",
            "telephone_number": "610-834-1122",
            "fax_number": "610-684-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTEKIND",
        "first_name": "PATRICIA",
        "middle_name": "DAWN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE1000515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.