NPIMap

Organization Active NPI

Hodi Lymphatic Center LLC

  • Occupational Therapist
  • Edwardsville, PA
National Provider Identifier
1508477084
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
HODI LYMPHATIC CENTER LLC
Practice address
115 Gateway Shopping Ctr
Edwardsville, PA 18704-4403
Phone
(570) 814-5977
NPI assigned
Aug 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Authorized official

Name
Candice Yendrzeiwski, OTNPI 1437770062
Title
OT, Owner
Phone
(570) 814-5977

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Environmental Modification Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XE0001X
Physical Rehabilitation Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0019X

Addresses

Primary practice location

115 Gateway Shopping Ctr
Edwardsville, PA 18704-4403

Mailing address

115 Gateway Shopping Ctr
Edwardsville, PA 18704-4403
Phone (570) 814-5977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200902001732 PA Part B Supplier - Clinic/Group Practice 3072930247 Receives reassigned benefits from 9 practitioners
Practice locations: Edwardsville, PA

National Provider Directory

National Provider Directory

Locations

115 Gateway Shopping Ctr
Kingston, PA 18704
Phone (570) 938-4634

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1508477084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 GATEWAY SHOPPING CTR",
            "city": "EDWARDSVILLE",
            "state": "PA",
            "postal_code": "187044403",
            "telephone_number": "570-814-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 GATEWAY SHOPPING CTR",
            "city": "EDWARDSVILLE",
            "state": "PA",
            "postal_code": "187044403",
            "telephone_number": "570-814-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HODI LYMPHATIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "YENDRZEIWSKI",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "OT, OWNER",
        "authorized_official_telephone_number": "570-814-5977",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.