Audrey Lauren Wirick, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

8604 Issued in TN

Practice address

444 Clinchfield St Ste 102
Kingsport, TN 37660-3859

Phone

(423) 212-5966

NPI assigned

Jun 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1184465734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ELMER WALKER RD",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376593149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST STE 102",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603859",
            "telephone_number": "423-212-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRICK",
        "first_name": "AUDREY",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "8604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Denise Winegar, N.P.
• Eric Bradley Wing, D.D.S.
• Adrianna Nicole Winseman
• Michael Jon Winsor, M.D.
• Randi Paige Winter
• Jon Wirshels, MSN, FNP-BC
• Brandie Wishon
• Mark L Withrow, MD
• Anchio Latwan Wolfe
• Robin Dewanna Wolfe, MED

• Physical Therapy Assistant in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.