Individual provider Active NPI

Creola L Woolery, PT, DPT

  • Pediatric Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1558057901
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
05012174A Issued in IN
Practice address
1002 Wishard Blvd Ste 2001
Indianapolis, IN 46202-4164
Phone
(317) 944-2801
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05012174A IN
Pediatric Physical Therapist 2251P0200X 05012174A IN Primary

Addresses

Primary practice location

1002 Wishard Blvd Ste 2001
Indianapolis, IN 46202-4164

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1002 Wishard Blvd Ste 4110
Indianapolis, IN 46202-4164
Phone (317) 944-8868

Other identifiers 1

IdentifierTypeStateIssuer
300084609MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwoolery@direct.iuhealth.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119001380 IN Practitioner - Physical Therapist in Private Practice 4385096916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health, Inc CurrentSince Jan 15, 2024 Accepting new patients

Locations

2242 Reliable Pkwy
Chicago, IL 60686

1002 Wishard Blvd
Indianapolis, IN 46202
Phone (317) 692-2300

1002 Wishard Blvd
Ste 4110
Indianapolis, IN 46202
Phone (317) 274-6450

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

1002 Wishard Blvd
Ste 2001
Indianapolis, IN 46202
Phone (317) 944-2801

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

2209 John R Wooden Dr
Martinsville, IN 46151
Phone (765) 342-3364

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": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1558057901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 WISHARD BLVD STE 2001",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462024164",
            "telephone_number": "317-944-2801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 Wishard Blvd Ste 4110",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462024164",
            "country_code": "US",
            "telephone_number": "317-944-8868",
            "fax_number": "317-944-6680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOLERY",
        "first_name": "CREOLA",
        "middle_name": "L",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05012174A",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IN",
            "license": "05012174A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300084609",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwoolery@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1002 Wishard Blvd Ste 4110",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462024164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.