NPIMap

Individual provider Active NPI

Andrea Wray Woolridge, D.P.T.

  • Physical Therapist
  • Sells, AZ
National Provider Identifier
1235208919
Registry record updated Sep 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3901 Issued in AZ
Practice address
Highway 86 and Topawa Rd
Sells, AZ 85634
Phone
(520) 295-2505
Fax
(520) 295-2677
NPI assigned
Nov 7, 2006
Last updated
Sep 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2010

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 3901 AZ Primary

Addresses

Primary practice location

Highway 86 and Topawa Rd
Sells, AZ 85634

Mailing address

7900 S J Stock Rd
Tucson, AZ 85746-7012
Phone (520) 295-2503

Other identifiers 1

IdentifierTypeStateIssuer
543414MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100220000026 TX Practitioner - Physical Therapist in Private Practice 1658415245 Reassigns benefits to 1 organization
I20210813000849 AZ Practitioner - Physical Therapist in Private Practice 1658415245 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3901AZMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix Area CurrentSince Jul 2, 2012 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Jul 2, 2012 Accepting new patients
White Mountain Physical Therapy LTD Physical Therapist CurrentSince Jul 1, 2021 Accepting new patients
Ton Santa Rosa Health Center Past Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Ton San Simon Health Center Past Accepting new patients
Ton Sells Hospital Past Accepting new patients
Kenai Kids Therapy Inc Physical Therapist Past Accepting new patients

Locations

4830 Highway 260
Ste 105
Lakeside, AZ 85929
Phone (928) 532-1221

29 W McNeil
Show Low, AZ 85901
Phone (928) 537-8196

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1235208919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 S J STOCK RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857467012",
            "telephone_number": "520-295-2503",
            "fax_number": "520-295-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 86 AND TOPAWA RD",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "85634",
            "telephone_number": "520-295-2505",
            "fax_number": "520-295-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLRIDGE",
        "first_name": "ANDREA",
        "middle_name": "WRAY",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "3901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "543414",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sells, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.