Andrew Dale Wofford, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5568 Issued in TN

Practice address

2735 Highway 64 Ste 107
Eads, TN 38028-3333

Phone

(901) 581-4539

NPI assigned

Sep 5, 2013

Last updated

Sep 5, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1902231236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2735 HIGHWAY 64 STE 107",
            "city": "EADS",
            "state": "TN",
            "postal_code": "380283333",
            "telephone_number": "901-581-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 HIGHWAY 64 STE 107",
            "city": "EADS",
            "state": "TN",
            "postal_code": "380283333",
            "telephone_number": "901-581-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOFFORD",
        "first_name": "ANDREW",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "5568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Eads, TN
• Providers in Eads, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.