Individual provider Active NPI

Kenneth Wrigley, P.A.

  • Physician Assistant
  • Elmira, NY
National Provider Identifier
1770641714
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000502 Issued in NY
Practice address
300 Hoffman St
Elmira, NY 14905-2263
Phone
(607) 734-4110
Fax
(607) 734-0344
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000502 NY Primary

Addresses

Primary practice location

300 Hoffman St
Elmira, NY 14905-2263

Mailing address

722 W Water St
Elmira, NY 14905-2435
Phone (607) 271-2050

Other identifiers 1

IdentifierTypeStateIssuer
01247621MedicaidNY

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000502NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Ogden Medical Center Past Accepting new patients
Arnot Ogden Medical Center 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1770641714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052435",
            "telephone_number": "607-271-2050",
            "fax_number": "607-271-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOFFMAN ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052263",
            "telephone_number": "607-734-4110",
            "fax_number": "607-734-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGLEY",
        "first_name": "KENNETH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "000502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01247621",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.