Active NPI
Terriellen Wood, PTA, COTA
- Physical Therapy Assistant
- Lebanon, NH
National Provider Identifier
1003093899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 0925
- Practice address
- 24 Old Etna Road
Lebanon, NH 03766 - Phone
- (603) 442-4207
- NPI assigned
- Jan 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 0566 | NH | |
| Occupational Therapy Assistant | 224Z00000X | 073-0000184 | VT | |
| Physical Therapy Assistant | 225200000X | 0925 | NH | Primary |
Addresses
Primary practice location
24 Old Etna Road
Lebanon, NH 03766
Mailing address
91 Mt. Hunger Road
Hartland, VT 05048
Phone (802) 436-2847
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 073-0000184 | VT | MD | Occupational Therapy Assistant |
| 0566 | NH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201132800000",
"number": "1003093899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 MT. HUNGER ROAD",
"city": "HARTLAND",
"state": "VT",
"postal_code": "05048",
"telephone_number": "802-436-2847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 OLD ETNA ROAD",
"city": "LEBANON",
"state": "NH",
"postal_code": "03766",
"telephone_number": "603-442-4207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "TERRIELLEN",
"name_prefix": "Mrs.",
"credential": "PTA, COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-24",
"last_updated": "2008-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NH",
"license": "0566",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VT",
"license": "073-0000184",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NH",
"license": "0925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.