Individual provider Active NPI

Paul Joseph McAndrew, P.T.

  • Physical Therapist
  • Durham, NC
National Provider Identifier
1932239241
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6879 Issued in NC
Practice address
3500 Westgate Dr Ste 504
Durham, NC 27707-2568
Phone
(919) 489-8809
Fax
(919) 489-5099
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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 6879 NC Primary

Addresses

Primary practice location

3500 Westgate Dr Ste 504
Durham, NC 27707-2568

Mailing address

6 E Pond Rd
Black Mountain, NC 28711-2584
Phone (199) 489-8809

Other identifiers 1

IdentifierTypeStateIssuer
7210443MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL wellnessstation.co

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000081 NC Practitioner - Physical Therapist in Private Practice 9638344526 Reassigns benefits to 1 organization
Practice locations: Durham, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6879NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Station LLC Physical Therapist CurrentSince Oct 1, 2015 Accepting new patients

Locations

3500 Westgate Dr
Ste 504
Durham, NC 27707
Phone (910) 212-4441

3001 Academy Rd
Ste 130
Durham, NC 27707
Phone (919) 489-8809

Organizations & group practices 1

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1932239241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E POND RD",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287112584",
            "telephone_number": "199-489-8809",
            "fax_number": "919-489-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 WESTGATE DR STE 504",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072568",
            "telephone_number": "919-489-8809",
            "fax_number": "919-489-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCANDREW",
        "first_name": "PAUL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "6879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7210443",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "wellnessstation.co",
            "affiliation": "N",
            "address_1": "3500 Westgate Dr Ste 504",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277072568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.