Individual provider Active NPI

Andrea L Wood, P.T.

  • Physical Therapist
  • Marysville, WA
National Provider Identifier
1477784130
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305206090 Issued in VA
Practice address
2701 171St PL NE
Suite 203
Marysville, WA 98271-4739
Phone
(360) 386-7401
Fax
(360) 386-7402
NPI assigned
Jul 29, 2009
Last updated
Oct 1, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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 2305206090 VA Primary

Addresses

Primary practice location

2701 171St PL NE
Suite 203
Marysville, WA 98271-4739

Mailing address

4220 132ND St SE
Suite 101
Mill Creek, WA 98012-8999
Phone (425) 357-9380

Other identifiers 5

IdentifierTypeStateIssuer
0301158OtherWAL & I
0301162OtherWAL & I
0301169OtherWAL & I
0328504OtherWAL & I
0301209OtherWAL & I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130103000338 WA Practitioner - Physical Therapist in Private Practice 7517110331 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10207 19TH Ave SE
Everett, WA 98208-4257
Phone (425) 337-3166

3201 Commercial Ave
Suite a
Anacortes, WA 98221-2761
Phone (360) 682-0361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305206090VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Oct 22, 2012 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Oct 22, 2012 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Oct 22, 2012 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC CurrentSince Oct 22, 2012 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Oct 22, 2012 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC Physical Therapist CurrentSince Oct 22, 2012 Accepting new patients

Locations

1300 W Sam Houston Pkwy S
Ste 300
Houston, TX 77042
Phone (713) 297-7052

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

2000 Hewitt Ave
Ste 115
Everett, WA 98201
Phone (425) 252-3908

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

2701 171st Pl NE
Ste 203
Marysville, WA 98271
Phone (360) 386-7401

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

111 Market St NE
Ste 108
Olympia, WA 98501
Phone (360) 754-7085

22500 NE Marketplace Dr
Ste 204
Redmond, WA 98053
Phone (425) 836-1034

1830 Bickford Ave
Ste 209
Snohomish, WA 98290
Phone (360) 568-7774

Organizations & group practices 6

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": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1477784130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 132ND ST SE",
            "address_2": "SUITE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980128999",
            "telephone_number": "425-357-9380",
            "fax_number": "425-357-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 171ST PL NE",
            "address_2": "SUITE 203",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982714739",
            "telephone_number": "360-386-7401",
            "fax_number": "360-386-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0301158",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0301162",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0301169",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0328504",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0301209",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.