Kenneth Woodruff, RPT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

5634 Issued in TN

Practice address

9047 Executive Park Dr
Suite 115
Knoxville, TN 37923-4605

Phone

(865) 531-5820

Fax

(865) 539-6461

NPI assigned

Oct 2, 2006

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

State licenses

Practice roles

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.

• Knoxville Integrated Developmental Services, Inc.

  • Speech-Language Pathologist
  • Knoxville, TN
  • NPI 1457525446
  NPD (past)
• Rehab Specialties, Inc.

  • Physical Therapist
  • Knoxville, TN
  • NPI 1467455196
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1003909110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9047 EXECUTIVE PARK DR",
            "address_2": "SUITE 115",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234605",
            "telephone_number": "865-531-5820",
            "fax_number": "865-539-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9047 EXECUTIVE PARK DR",
            "address_2": "SUITE 115",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234605",
            "telephone_number": "865-531-5820",
            "fax_number": "865-539-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "TN",
            "license": "5634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Hope Woodby
• Doris Moral Woodhull
• Woodrow W Gwinn Jr
• Woodrow W. Gwinn, Jr.
• Demond Woodruff, BA
• Kristine Alees Woodrum, ATC
• Adaisha Woods
• Herneaschia Woods, PMHNP
• Karen J Woods, OT
• Kristen Woods, LCSW

• Geriatric Physical Therapist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Geriatric Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.

Verify at the official NPI Registry.