Individual provider Active NPI

Geoffrey N Wright, PT

  • Physical Therapist
  • Sterling, IL
National Provider Identifier
1306195458
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070019484 Issued in IL
Practice address
100 E Lefevre Rd
Sterling, IL 61081-1278
Phone
(815) 625-0400
Fax
(815) 626-2896
NPI assigned
Sep 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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 070019484 IL Primary

Addresses

Primary practice location

100 E Lefevre Rd
Sterling, IL 61081-1278

Mailing address

100 E Lefevre Rd
Sterling, IL 61081-1278
Phone (815) 625-0400

Other identifiers 1

IdentifierTypeStateIssuer
070019484OtherILIL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121128000434 IL Practitioner - Physical Therapist in Private Practice 5294987103 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070019484ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center Current Accepting new patients
CGH Medical Center CurrentSince Jan 1, 2014 Accepting new patients
CGH Medical Center CurrentSince Jan 1, 2014 Accepting new patients

Locations

711 S Division Ave
Polo, IL 61064
Phone (815) 946-3661

100 E Lefevre Rd
Sterling, IL 61081
Phone (815) 625-0400

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

Organizations & group practices 3

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": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1306195458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LEFEVRE RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811278",
            "telephone_number": "815-625-0400",
            "fax_number": "815-626-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LEFEVRE RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811278",
            "telephone_number": "815-625-0400",
            "fax_number": "815-626-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "GEOFFREY",
        "middle_name": "N",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "070019484",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.