Individual provider Active NPI

Andrea Wysochansky Cheddar, DPT

  • Physical Therapist
  • Danville, PA
National Provider Identifier
1679700777
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT019908 Issued in PA
Practice address
603 E Market St Ste 100
Danville, PA 17821-2161
Phone
(570) 275-4715
Fax
(570) 275-4695
NPI assigned
Jun 16, 2009
Last updated
Jan 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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 PT019908 PA Primary

Addresses

Primary practice location

603 E Market St Ste 100
Danville, PA 17821-2161

Mailing address

430 Innovation Drive
Blairsville, PA 15717-8096
Phone (724) 343-4060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT019908PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Rehabilitation and Health Services, Inc. Physical Therapist Past Accepting new patients
Phoenix Rehabilitation and Health Services, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1679700777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 INNOVATION DRIVE",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157178096",
            "telephone_number": "724-343-4060",
            "fax_number": "724-343-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E MARKET ST STE 100",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178212161",
            "telephone_number": "570-275-4715",
            "fax_number": "570-275-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEDDAR",
        "first_name": "ANDREA",
        "middle_name": "WYSOCHANSKY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT019908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.