Individual provider Active NPI

Adrienne L Wickwire, DPT

  • Orthopedic Physical Therapist
  • Enola, PA
National Provider Identifier
1851723555
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT022809 Issued in PA
Practice address
2250 Millennium Way
Suite 400
Enola, PA 17025-1488
Phone
(717) 732-8131
Fax
(717) 732-8132
NPI assigned
Aug 5, 2013
Last updated
Apr 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT022809 PA
Orthopedic Physical Therapist 2251X0800X PT022809 PA Primary

Addresses

Primary practice location

2250 Millennium Way
Suite 400
Enola, PA 17025-1488

Mailing address

1005 Crystal Creek Dr
Mechanicsburg, PA 17050-1966
Phone (717) 554-6140

Other names 1

  • Adrienne L Beauduy Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140314000863 PA Practitioner - Physical Therapist in Private Practice 1658502653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Surgeons LTDGroup PAC ID 4385535244, 92 clinicians

Practice addresses (Care Compare)

450 Powers Ave
Harrisburg, PA 17109-5933
Phone (717) 920-4950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT022809PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Surgeons LTD Physical Therapist CurrentSince Apr 22, 2022 Accepting new patients
Orthopedic Surgeons LTD Physical Therapist Past Accepting new patients

Locations

3399 Trindle Rd
Camp Hill, PA 17011
Phone (717) 901-4236

450 Powers Ave
Lowr
Harrisburg, PA 17109
Phone (717) 920-4950

450 Powers Ave
Lower Paxton, PA 17109
Phone (717) 615-1409

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, 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": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1851723555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 CRYSTAL CREEK DR",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170501966",
            "telephone_number": "717-554-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 MILLENNIUM WAY",
            "address_2": "SUITE 400",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251488",
            "telephone_number": "717-732-8131",
            "fax_number": "717-732-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKWIRE",
        "first_name": "ADRIENNE",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022809",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT022809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "BEAUDUY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Enola, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.