Individual provider Active NPI

Peggy McWilliams

  • Physical Therapist
  • New Albany, IN
National Provider Identifier
1811354517
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2632 Grant Line Rd
New Albany, IN 47150-4000
Phone
(812) 944-9048
NPI assigned
Jan 26, 2016
Last updated
Oct 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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 Primary

Addresses

Primary practice location

2632 Grant Line Rd
New Albany, IN 47150-4000

Mailing address

16999 Green Crest LN
Louisville, KY 40245-3217

Other practice location 1

3526 Dutchmans Ln
Louisville, KY 40205-3256
Phone (502) 452-6331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220103001284 KY Practitioner - Physical Therapist in Private Practice 8628300613 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jan 3, 2022 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jan 3, 2022 Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1811354517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16999 GREEN CREST LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402453217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 GRANT LINE RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504000",
            "telephone_number": "812-944-9048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3526 Dutchmans Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402053256",
            "country_code": "US",
            "telephone_number": "502-452-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "PEGGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.