Active NPI
David Wooster
- Physical Therapy Assistant
- Mobile, AL
National Provider Identifier
1164639852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA1396
- Practice address
- 1515 University Blvd S
Mobile, AL 36609-2958 - Phone
- (251) 343-9600
- Fax
- (251) 380-3328
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA1396 | AL | Primary |
Addresses
Primary practice location
1515 University Blvd S
Mobile, AL 36609-2958
Mailing address
28003 Oakachoy Loop
Daphne, AL 36526
Phone (251) 343-9600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA1396 | Other | AL | STATE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA1396 | AL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164639852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28003 OAKACHOY LOOP",
"city": "DAPHNE",
"state": "AL",
"postal_code": "36526",
"telephone_number": "251-343-9600",
"fax_number": "251-380-3328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 UNIVERSITY BLVD S",
"city": "MOBILE",
"state": "AL",
"postal_code": "366092958",
"telephone_number": "251-343-9600",
"fax_number": "251-380-3328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOSTER",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "PTA1396",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PTA1396",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.