Individual provider Active NPI

Olivia Noone

  • Physical Therapist
  • Wyalusing, PA
National Provider Identifier
1710693205
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
TPT023636 Issued in PA
Practice address
42 Complex Dr
Wyalusing, PA 18853-7803
Phone
(570) 746-0504
NPI assigned
Jan 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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 TPT023636 PA Primary

Addresses

Primary practice location

42 Complex Dr
Wyalusing, PA 18853-7803

Mailing address

531 Wilson Rd
Wyalusing, PA 18853-8485

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230614000595 PA Practitioner - Physical Therapist in Private Practice 5294193819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pivot Physical Therapy of Pennsylvania LLCGroup PAC ID 4981971843, 123 clinicians

Practice addresses (Care Compare)

116 Walnut St
Athens, PA 18810-1735
Phone (570) 888-0057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TPT023636PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Physical Therapy Inc Physical Therapist CurrentSince Jan 29, 2023 Accepting new patients
Pivot Physical Therapy of Pennsylvania, LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Dynamic Therapy Services, LLC Physical Therapist Past Accepting new patients

Locations

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

116 Walnut St
Athens, PA 18810
Phone (570) 888-0057

655 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2142

130 W Main St
Ste 100B
Trappe, PA 19426
Phone (484) 471-6850

7731 Route 6
Troy, PA 16947
Phone (570) 297-2774

42 Complex Dr
Wyalusing, PA 18853
Phone (570) 746-0504

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": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1710693205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 WILSON RD",
            "city": "WYALUSING",
            "state": "PA",
            "postal_code": "188538485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 COMPLEX DR",
            "city": "WYALUSING",
            "state": "PA",
            "postal_code": "188537803",
            "telephone_number": "570-746-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONE",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "TPT023636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyalusing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.