Individual provider Active NPI

Edwin Scott Wills, PT

  • Physical Therapist
  • Pompton Plains, NJ
National Provider Identifier
1659307494
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QAO352800 Issued in NJ
Practice address
465 Route 23
Pompton Plains, NJ 07444-1814
Phone
(973) 513-9055
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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 40QAO352800 NJ Primary

Addresses

Primary practice location

465 Route 23
Pompton Plains, NJ 07444-1814

Mailing address

98 Berkley CT
Wayne, NJ 07470-2446
Phone (973) 389-8248

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090128000009 NJ Practitioner - Physical Therapist in Private Practice 2961434113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healing Hands Rehab IncGroup PAC ID 7911932561, 5 clinicians

Practice addresses (Care Compare)

1479 State Route 23 201
Wayne, NJ 07470-7507
Phone (973) 772-8006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QAO352800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Rehab Inc Physical Therapist CurrentSince Jul 21, 2019 Accepting new patients
Chilton Sports Medicine & Rehabilitation Management Inc. Physical Therapist PastSince Jun 1, 2005 Accepting new patients
Healing Hands Rehab Inc PastSince Jul 21, 2019 Accepting new patients
Best Care Medical Supply Co. Inc. Past Accepting new patients

Locations

61 Lakeview Ave
Clifton, NJ 07011
Phone (973) 478-8300

1479 State Route 23
Ste 201
Wayne, NJ 07470
Phone (973) 686-0007

Organizations & group practices 4

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1659307494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 BERKLEY CT",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702446",
            "telephone_number": "973-389-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 ROUTE 23",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441814",
            "telephone_number": "973-513-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "EDWIN",
        "middle_name": "SCOTT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QAO352800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Plains, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.