Derek Matthew Wood, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-4930 Issued in ID

Practice address

172 2ND St S
Nampa, ID 83651-3708

Phone

(208) 385-3620

NPI assigned

Feb 15, 2017

Last updated

Feb 15, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  OR

  Medicare reassignment NPD
• St Lukes Clinic-Treasure Valley LLC

  dba St Lukes RHC - EOMA

  • Rural Health Clinic/Center
  • Baker City, OR
  • NPI 1336442607
  NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1073052635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 2ND ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 2ND ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513708",
            "telephone_number": "208-385-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "DEREK",
        "middle_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-4930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah D Witte, FAMILY NURSE PRACTIT
• Wmcesa (Women's Medical Clinic)
• Gisela Woggon, M.A., LMFT
• Heather R Wolcott, PHARMD
• William Chad Wolff, DDS
• Gregory Leon Wood, FNP
• Kimberly Rae Wood, LPC
• Matthew J. Wood, MD
• Deborah L Woodall, LCSW
• Kenneth Woodward

• Physical Therapist in Nampa, ID
• Providers in Nampa, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.