NPIMap

Individual provider Active NPI

Jessica Wlodarski

  • Physical Therapist
  • West End, NC
National Provider Identifier
1104430347
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1163 7 Lakes Dr
West End, NC 27376
Phone
(910) 673-5437
Fax
(910) 673-5438
NPI assigned
Sep 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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 Primary

Addresses

Primary practice location

1163 7 Lakes Dr
West End, NC 27376

Mailing address

PO Box 354
West End, NC 27376-0354
Phone (910) 673-5437

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

Practice roles

OrganizationSpecialtyStatusNew patients
Move With Me Physical Therapy, LLC Past Accepting new patients
Moore Pediatric Therapy Serivces PastSince Sep 6, 2020 Accepting new patients
Moore Pediatric Therapy Serivces PastSince Sep 6, 2020 Accepting new patients

Organizations & group practices 3

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": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1104430347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 354",
            "city": "WEST END",
            "state": "NC",
            "postal_code": "273760354",
            "telephone_number": "910-673-5437",
            "fax_number": "910-673-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 7 LAKES DR",
            "city": "WEST END",
            "state": "NC",
            "postal_code": "27376",
            "telephone_number": "910-673-5437",
            "fax_number": "910-673-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WLODARSKI",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West End, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.