Active NPI
Pauline Wong, PT
- Physical Therapist
- Newburgh, IN
National Provider Identifier
1427174242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05006734A
- Practice address
- 8300 Bell Oaks Dr
Newburgh, IN 47630-2585 - Phone
- (812) 858-1008
- Fax
- (812) 858-1001
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05006734A | IN | Primary |
Addresses
Primary practice location
8300 Bell Oaks Dr
Newburgh, IN 47630-2585
Mailing address
3324 Cobblefield Dr
Evansville, IN 47711-2282
Phone (812) 475-1311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05006734A | Other | IN | PT LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05006734A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newburgh Chiropractic PSC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Newburgh, IN
- NPI 1447461132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427174242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3324 COBBLEFIELD DR",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477112282",
"telephone_number": "812-475-1311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8300 BELL OAKS DR",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476302585",
"telephone_number": "812-858-1008",
"fax_number": "812-858-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "PAULINE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05006734A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "05006734A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newburgh, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.