NPIMap

Individual provider Active NPI

Audrey Linn List, PT

  • Physical Therapist
  • Fayetteville, PA
National Provider Identifier
1508908260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009779-L Issued in PA
Practice address
6743 Fairway Dr E
Fayetteville, PA 17222-9400
Phone
(717) 360-3989
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 PT009779-L PA Primary

Addresses

Primary practice location

6743 Fairway Dr E
Fayetteville, PA 17222-9400

Mailing address

6743 Fairway Dr E
Fayetteville, PA 17222-9400
Phone (717) 360-3989

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

LicenseStateTypeSpecialty
PT009779-LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Easter Seals Central PA Past Accepting new patients
Childhood Early Intervention, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508908260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6743 FAIRWAY DR E",
            "city": "FAYETTEVILLE",
            "state": "PA",
            "postal_code": "172229400",
            "telephone_number": "717-360-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6743 FAIRWAY DR E",
            "city": "FAYETTEVILLE",
            "state": "PA",
            "postal_code": "172229400",
            "telephone_number": "717-360-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIST",
        "first_name": "AUDREY",
        "middle_name": "LINN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT009779-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, PA

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.

Verify at the official NPI Registry.