Individual provider Active NPI

Sally Minnich Wooldridge, OT

  • Hand Occupational Therapist
  • Newport News, VA
National Provider Identifier
1326154071
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
0119000085 Issued in VA
Practice address
11712 Jefferson Ave
Suite D
Newport News, VA 23606-4406
Phone
(757) 595-4880
Fax
(757) 595-4886
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 0119000085 VA Primary

Addresses

Primary practice location

11712 Jefferson Ave
Suite D
Newport News, VA 23606-4406

Mailing address

11712 Jefferson Ave
Suite D
Newport News, VA 23606-4406
Phone (757) 595-4880

Other identifiers 1

IdentifierTypeStateIssuer
010029171MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119000085VAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Hand Therapy LLC Hand PastSince Dec 1, 2002 Accepting new patients
Pinnacle Hand Therapy Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1326154071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11712 JEFFERSON AVE",
            "address_2": "SUITE D",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064406",
            "telephone_number": "757-595-4880",
            "fax_number": "757-595-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11712 JEFFERSON AVE",
            "address_2": "SUITE D",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064406",
            "telephone_number": "757-595-4880",
            "fax_number": "757-595-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLDRIDGE",
        "first_name": "SALLY",
        "middle_name": "MINNICH",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "VA",
            "license": "0119000085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010029171",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.