Active NPI
Kylie Mae Woodard, PT
- Physical Therapist
- Calhoun, GA
National Provider Identifier
1043764640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTO12523
- Practice address
- 136 W Belmont Dr
Suite 12
Calhoun, GA 30701-3064 - Phone
- (706) 625-0662
- Fax
- (706) 625-0582
- NPI assigned
- Aug 11, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTO12523 | GA | Primary |
Addresses
Primary practice location
136 W Belmont Dr
Suite 12
Calhoun, GA 30701-3064
Mailing address
136 W Belmont Dr
Suite 12
Calhoun, GA 30701-3064
Phone (706) 625-0662
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTO12523 | Other | GA | PT LICENSE |
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 |
|---|---|---|---|
| PTO12523 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521417600000",
"number": "1043764640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 W BELMONT DR",
"address_2": "SUITE 12",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307013064",
"telephone_number": "706-625-0662",
"fax_number": "706-625-0582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 W BELMONT DR",
"address_2": "SUITE 12",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307013064",
"telephone_number": "706-625-0662",
"fax_number": "706-625-0582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODARD",
"first_name": "KYLIE",
"middle_name": "MAE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-11",
"last_updated": "2018-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PTO12523",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "PTO12523",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Calhoun, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.