Diane J. Wooldridge, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11156 Issued in SC

Practice address

439 Channel Rd Ste 102
Lake Wylie, SC 29710-6101

Phone

(803) 746-7800

NPI assigned

Jul 8, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ivyrehab Focus, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Lake Wylie, SC
  • NPI 1518105279

  Physical Therapist

  NPD
• Ivyrehab Focus, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Rock Hill, SC
  • NPI 1902443880
  NPD
• Megamotion Physical Therapy

  • Physical Therapy Clinic/Center
  • Milford, NY
  • NPI 1770030322
  NPD (past)

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1275531675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050",
            "fax_number": "315-853-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 CHANNEL RD STE 102",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297106101",
            "telephone_number": "803-746-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLDRIDGE",
        "first_name": "DIANE",
        "middle_name": "J.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "009744-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Well-Balanced at Home Physical Therapy LLC
• Sarah West
• Kelly Michelle White, LCMHC
• Hannah Wilkerson
• Jill R Winter, PT
• Dana Michele Wurm, MS, OTR, CLT

• Physical Therapist in Lake Wylie, SC
• Providers in Lake Wylie, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.