Individual provider Active NPI

Duke Wade Hartwell, PT

  • Physical Therapist
  • Columbus, IN
National Provider Identifier
1124066485
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05008884A Issued in IN
Practice address
4420 W Jonathan Moore Pike
Columbus, IN 47201-4685
Phone
(812) 342-4211
Fax
(812) 342-2413
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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 05008884A IN Primary

Addresses

Primary practice location

4420 W Jonathan Moore Pike
Columbus, IN 47201-4685

Mailing address

806 Jackson St
Columbus, IN 47201-6264
Phone (812) 748-3412

Other practice location 1

1639 N National Rd
Columbus, IN 47201-5579
Phone (812) 669-1687

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061030000445 IN Practitioner - Physical Therapist in Private Practice 0547267841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

4895 Pine Ridge Dr
Columbus, IN 47201-2569
Phone (812) 342-3098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Feb 27, 2025 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Feb 27, 2025 Accepting new patients
Elite Therapy Corp PastSince Sep 1, 2019 Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 4

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1124066485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JACKSON ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016264",
            "telephone_number": "812-748-3412",
            "fax_number": "812-377-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 W JONATHAN MOORE PIKE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472014685",
            "telephone_number": "812-342-4211",
            "fax_number": "812-342-2413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1639 N National Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "IN",
            "postal_code": "472015579",
            "country_code": "US",
            "telephone_number": "812-669-1687",
            "fax_number": "815-775-1035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTWELL",
        "first_name": "DUKE",
        "middle_name": "WADE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008884A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.