Active NPI
Ronald Wooten, P.T.
- Physical Therapist
- West Union, SC
National Provider Identifier
1003020587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2105
- Practice address
- 148 Foothills Ctr Dr
Ste 148
West Union, SC 29696-2518 - Phone
- (864) 638-6405
- Fax
- (864) 638-6421
- NPI assigned
- May 10, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2105 | SC | Primary |
Addresses
Primary practice location
148 Foothills Ctr Dr
Ste 148
West Union, SC 29696-2518
Mailing address
148 Foothills Ctr Dr
Ste 148
West Union, SC 29696-2518
Phone (864) 638-6405
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2105 | SC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1003020587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 FOOTHILLS CTR DR",
"address_2": "STE 148",
"city": "WEST UNION",
"state": "SC",
"postal_code": "296962518",
"telephone_number": "864-638-6405",
"fax_number": "864-638-6421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 FOOTHILLS CTR DR",
"address_2": "STE 148",
"city": "WEST UNION",
"state": "SC",
"postal_code": "296962518",
"telephone_number": "864-638-6405",
"fax_number": "864-638-6421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOTEN",
"first_name": "RONALD",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "2105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Union, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.