Individual provider Active NPI

Theresa R Wolfe, M.D.

  • Spinal Cord Injury Medicine Physician
  • Lexington, KY
National Provider Identifier
1316152069
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Spinal Cord Injury Medicine PhysicianTaxonomy code 2081P0004X
License
44623 Issued in KY
Practice address
1207 S Broadway
Lexington, KY 40504-2701
Phone
(859) 258-4312
NPI assigned
May 14, 2007
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Spinal Cord Injury Medicine Physician 2081P0004X 44623 KY Primary

Addresses

Primary practice location

1207 S Broadway
Lexington, KY 40504-2701

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200

Other practice location 1

1101 Veterans Dr
Lexington, KY 40502-2235
Phone (859) 233-4511 ext. 2589

Other identifiers 1

IdentifierTypeStateIssuer
7100175110MedicaidKY

Other names 1

  • Theresa R Kent Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110907001103 KY Practitioner - Physical Medicine and Rehabilitation 3870763527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
JC Edwards School of Medicine, Marshall University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

710 N Carol Malone Boulevard
Suite a
Grayson, KY 41143-1126
Phone (606) 474-0157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44623KYMDSpinal Cord Injury Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Lexington Clinic PSC CurrentSince Oct 10, 2023 Accepting new patients
New Lexington Clinic, PSC CurrentSince Oct 10, 2023 Accepting new patients

Locations

1207 S Broadway
Lexington, KY 40504
Phone (859) 258-8519

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

Interoperability endpoints

  • Direct secure messaging: theresa.wolfe.1@13059.direct.athenahealth.com

Organizations & group practices 2

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1316152069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Veterans Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405022235",
            "country_code": "US",
            "telephone_number": "859-233-4511 x2589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "THERESA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "KY",
            "license": "44623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100175110",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "KENT",
            "middle_name": "R",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.