Larissa Marie Wander, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017679 Issued in OH

Practice address

35840 Chester Rd
Suite F
Avon, OH 44011

Phone

(440) 937-5210

Fax

(440) 937-5212

NPI assigned

Oct 8, 2018

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

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PT Link LLCGroup PAC ID 4587805940, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• PT Link LLC

  • Physical Therapist
  • Toledo, OH
  • NPI 1902149990
  Medicare reassignment Care Compare group NPD
• Swetlic Chiropractic & Rehabilitation Center, Inc

  • Chiropractor
  • Mount Vernon, OH
  • NPI 1265629356
  Medicare reassignment
• Lets Get Physical Therapy Group LLC

  • Physical Therapist
  • Avon, OH
  • NPI 1053457002
  NPD (past)

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1669947461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35840 CHESTER RD",
            "address_2": "SUITE F",
            "city": "AVON",
            "state": "OH",
            "postal_code": "44011",
            "telephone_number": "440-937-5210",
            "fax_number": "440-937-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35840 CHESTER RD",
            "address_2": "SUITE F",
            "city": "AVON",
            "state": "OH",
            "postal_code": "44011",
            "telephone_number": "440-937-5210",
            "fax_number": "440-937-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDER",
        "first_name": "LARISSA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT017679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coulton Michael Waite, PA-C
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Latanisha Monique Walker White
• Melissa A Wallace, PT
• Eric Ward, OD
• Songcerae Washington, PA-C
• Marwan Wassouf, MD
• Christina Marie Watkins, CNP
• John Thomas Webster, D.D.S

• Physical Therapist in Avon, OH
• Providers in Avon, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.