Individual provider Active NPI

Adam Wooden, MPT

  • Physical Therapist
  • Lebanon, PA
National Provider Identifier
1689991986
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT030387 Issued in PA
Practice address
1701 Cornwall Rd Ste 200
Lebanon, PA 17042-7480
Phone
(717) 299-4871
Fax
(717) 391-2494
NPI assigned
Apr 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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 PT 36691 CA
Physical Therapist 225100000X PT030387 PA Primary

Addresses

Primary practice location

1701 Cornwall Rd Ste 200
Lebanon, PA 17042-7480

Mailing address

170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone (717) 299-4871

Other practice location 1

1460 Drew Ave Ste 200
Davis, CA 95618-4856
Phone (530) 753-9011

Other practice location 2

212 Willow Valley Lakes Dr Ste 201
Willow Street, PA 17584-9668
Phone (172) 994-8717

Other practice location 3

170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone (717) 299-4871

Other practice location 4

2913 Spooky Nook Rd Ste 100
Manheim, PA 17545-9149
Phone (717) 299-4871

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718000687 PA Practitioner - Physical Therapist in Private Practice 8325176035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Assoc of Lancaster LTDGroup PAC ID 8527041987, 81 clinicians

Practice addresses (Care Compare)

170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone (717) 299-4871

1701 Cornwall Rd
Suite 200
Lebanon, PA 17042-7480
Phone (717) 299-4871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36691CAMDChiropractor
PT 36691CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Assoc of Lancaster LTD CurrentSince Jun 20, 2022 Accepting new patients
Orthopedic Assoc of Lancaster LTD CurrentSince Jun 20, 2022 Accepting new patients
Physical Edge Specialty Services Physical Therapist PastSince Sep 6, 2020 Accepting new patients

Locations

170 N Pointe Blvd
Lancaster, PA 17601

1701 Cornwall Rd
Ste 200
Lebanon, PA 17042

2913 Spooky Nook Rd
Ste 100
Manheim, PA 17545

212 Willow Valley Lakes Dr
Ste 201
Willow Street, PA 17584

Organizations & group practices 3

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": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1689991986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 N POINTE BLVD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014132",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 CORNWALL RD STE 200",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427480",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1460 Drew Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Davis",
            "state": "CA",
            "postal_code": "956184856",
            "country_code": "US",
            "telephone_number": "530-753-9011",
            "fax_number": "530-753-9021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 Willow Valley Lakes Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Willow Street",
            "state": "PA",
            "postal_code": "175849668",
            "country_code": "US",
            "telephone_number": "172-994-8717",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 N Pointe Blvd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176014132",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2913 Spooky Nook Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Manheim",
            "state": "PA",
            "postal_code": "175459149",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODEN",
        "first_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-26",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 36691",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.