Individual provider Active NPI

Ann M Wordekemper-Crain, PT

  • Physical Therapist
  • Springfield, IL
National Provider Identifier
1396934345
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1200 W Jefferson St
Suite D
Springfield, IL 62702-3694
Phone
(217) 726-8502
Fax
(217) 726-8568
NPI assigned
Oct 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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 IL Primary

Addresses

Primary practice location

1200 W Jefferson St
Suite D
Springfield, IL 62702-3694

Mailing address

1200 W Jefferson St
Suite D
Springfield, IL 62702-3694
Phone (217) 726-8502

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
070-008682ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1396934345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W JEFFERSON ST",
            "address_2": "SUITE D",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023694",
            "telephone_number": "217-726-8502",
            "fax_number": "217-726-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W JEFFERSON ST",
            "address_2": "SUITE D",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023694",
            "telephone_number": "217-726-8502",
            "fax_number": "217-726-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORDEKEMPER-CRAIN",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.