Individual provider Active NPI

Kathleen Woodcock, LPTA

  • Physical Therapy Assistant
  • Pittsfield, IL
National Provider Identifier
1003233768
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160000211 Issued in IL
Practice address
610 Lowry St
Pittsfield, IL 62363-1768
Phone
(217) 285-5200
Fax
(217) 285-5212
NPI assigned
Mar 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160000211 IL Primary

Addresses

Primary practice location

610 Lowry St
Pittsfield, IL 62363-1768

Mailing address

610 Lowry St
Pittsfield, IL 62363-1768
Phone (217) 285-5200

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

LicenseStateTypeSpecialty
160000211ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1003233768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 LOWRY ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631768",
            "telephone_number": "217-285-5200",
            "fax_number": "217-285-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 LOWRY ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631768",
            "telephone_number": "217-285-5200",
            "fax_number": "217-285-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODCOCK",
        "first_name": "KATHLEEN",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160000211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.