Active NPI
Kenneth Wrigley, P.A.
- Physician Assistant
- Elmira, NY
National Provider Identifier
1770641714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 000502
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01247621 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000502 | NY | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Acute Care Hospital
- Elmira, NY
- NPI 1083605661
-
- Internal Medicine Physician
- Elmira, NY
- NPI 1265580286
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.