Taylor A Wood

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502005817 Issued in MI

Practice address

6615 Linck Rd
Brown City, MI 48416-9672

Phone

(810) 728-8380

NPI assigned

Apr 4, 2019

Last updated

Apr 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1043772353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 LINCK RD",
            "city": "BROWN CITY",
            "state": "MI",
            "postal_code": "484169672",
            "telephone_number": "810-728-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 LINCK RD",
            "city": "BROWN CITY",
            "state": "MI",
            "postal_code": "484169672",
            "telephone_number": "810-728-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "TAYLOR",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005817",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2145107",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Parr
• Kelly Jo Pavel, MA, LLPC
• Professional Rehab Services Inc. (Thibodeau Physical Therapy)
• Robert T Brengel DO & Olan C Dombroske DO, PTRS
• Kimberly L Verellen, PA-C

• Physical Therapy Assistant in Brown City, MI
• Providers in Brown City, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.