Andrea M Yannelli-Clark, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT002842E Issued in PA

Practice address

1270 Broadcasting Rd
Wyomissing, PA 19610-3203

Phone

(610) 372-1586

Fax

(610) 372-1589

NPI assigned

Aug 9, 2005

Last updated

Oct 12, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Andrea M Yannelli Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1427059906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 BROADCASTING RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103203",
            "telephone_number": "610-372-1586",
            "fax_number": "610-372-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 BROADCASTING RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103203",
            "telephone_number": "610-372-1586",
            "fax_number": "610-372-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANNELLI-CLARK",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT002842E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "643454",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50071312",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "YANNELLI",
            "middle_name": "M",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wyomissing Optometric Center, Inc.
• Wyomissing Surgical Clinic, LTD. (Spring Ridge Surgical Specialists)
• Wyomissing Surgical Services Inc.
• Wypa Anesthesia, LLC
• Amanda Yahn
• Heather Marie Yannuzzi
• Alissa Rayann Yenser, MS, LAT, ATC
• Cheryl L Yesavage, PA-C
• Luann Yocom, RPH
• Brady Yocum

• Physical Therapist in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.