Individual provider Active NPI

Vincent M Whalen, PT, MS, OCS, NCS

  • Physical Therapist
  • Wadsworth, OH
National Provider Identifier
1528057536
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4688 Issued in OH
Practice address
145 Smokerise Dr
Wadsworth, OH 44281-8702
Phone
(330) 335-4200
Fax
(330) 335-7131
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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 4688 OH Primary

Addresses

Primary practice location

145 Smokerise Dr
Wadsworth, OH 44281-8702

Mailing address

145 Smokerise Dr
Wadsworth, OH 44281-8702
Phone (330) 335-4200

Other identifiers 1

IdentifierTypeStateIssuer
0968529MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120113000355 OH Practitioner - Physical Therapist in Private Practice 2466425673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wadsworth Family Physical Therapy IncGroup PAC ID 0648243857, 8 clinicians

Practice addresses (Care Compare)

145 Smokerise Dr
Wadsworth, OH 44281-8702
Phone (330) 335-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4688OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wadsworth Family Physical Therapy Inc Physical Therapist CurrentSince Apr 1, 1995 Accepting new patients

Locations

145 Smokerise Dr
Wadsworth, OH 44281
Phone (330) 335-4200

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.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1528057536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 SMOKERISE DR",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818702",
            "telephone_number": "330-335-4200",
            "fax_number": "330-335-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 SMOKERISE DR",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818702",
            "telephone_number": "330-335-4200",
            "fax_number": "330-335-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "VINCENT",
        "middle_name": "M",
        "credential": "PT, MS, OCS, NCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "4688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0968529",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.