Individual provider Active NPI

Andrea Wainright, PTA

  • Physical Therapy Assistant
  • Peoria, IL
National Provider Identifier
1730780842
Registry record updated Nov 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
0003586 Issued in IL
Practice address
3535 N Rochelle LN
Peoria, IL 61604-1036
Phone
(309) 685-8800
NPI assigned
Nov 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0003586 IL Primary

Addresses

Primary practice location

3535 N Rochelle LN
Peoria, IL 61604-1036

Mailing address

816 S Johanson Rd
Peoria, IL 61607-1088
Phone (309) 696-5911

Other practice location 1

6901 N Galena Rd
Peoria, IL 61614-3193
Phone (309) 689-2383

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0003586ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604707200000",
    "number": "1730780842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 S JOHANSON RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616071088",
            "telephone_number": "309-696-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N ROCHELLE LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616041036",
            "telephone_number": "309-685-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6901 N Galena Rd",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616143193",
            "country_code": "US",
            "telephone_number": "309-689-2383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAINRIGHT",
        "first_name": "ANDREA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "0003586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2020; 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.