Individual provider Active NPI

Michael Woodland, PTA

  • Physical Therapy Assistant
  • Spokane, WA
National Provider Identifier
1043745359
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P1 60711913 Issued in WA
Practice address
3151 E 29TH Ave
Spokane, WA 99223-4800
Phone
(509) 532-0500
Fax
(509) 532-8810
NPI assigned
Apr 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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 P1 60711913 WA Primary

Addresses

Primary practice location

3151 E 29TH Ave
Spokane, WA 99223-4800

Mailing address

3151 E 29TH Ave
Spokane, WA 99223-4800
Phone (509) 532-0500

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
P1 60711913WAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Foot Clinic, P S Past Accepting new patients
Larry Ham and Associates Physical Therapy PS PastSince Oct 7, 2004 Accepting new patients

Organizations & group practices 2

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1043745359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 E 29TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234800",
            "telephone_number": "509-532-0500",
            "fax_number": "509-532-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 E 29TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234800",
            "telephone_number": "509-532-0500",
            "fax_number": "509-532-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODLAND",
        "first_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60711913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.