Jodi Wadge

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501005505 Issued in MI

Practice address

601 S Westwood Ave
Kingsford, MI 49802-1109

Phone

(906) 779-1880

Fax

(906) 779-0818

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foundations Health and Physical Medicine 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Foundations Health & Physical Medicine

  • Multi-Specialty Clinic/Center
  • Norway, MI
  • NPI 1255058749

  MI

  Medicare reassignment Care Compare group NPD
• Biancos Physical Therapy & Wellness Center

  • Physical Therapist
  • Kingsford, MI
  • NPI 1063557270
  NPD (past)
• Iron Mountain Wellness Way LLC

  • Chiropractor
  • Kingsford, MI
  • NPI 1902647787
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1639214844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S WESTWOOD AVE",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498021109",
            "telephone_number": "906-779-1880",
            "fax_number": "906-779-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S WESTWOOD AVE",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498021109",
            "telephone_number": "906-779-1880",
            "fax_number": "906-779-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADGE",
        "first_name": "JODI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0B20009",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela C Tripp, PTA
• Suzanne Tusa
• Up Rehab Services LLC
• Curtis Vandusen
• Amy Venstra
• Kelsey Wagner, BT
• Debra Ann Wahoviak, LBSW
• Deborah Walker
• Janet Whedon, LMSW
• George Thomas Wiedenhoeft, LMSW

• All providers in Kingsford, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.