Individual provider Active NPI

Jessika R Woodward, DPT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1083261846
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT297232 Issued in CA
Practice address
1625 Stockton Blvd
Sacramento, CA 95816-7097
Phone
(916) 262-9035
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT297232 CA Primary

Addresses

Primary practice location

1625 Stockton Blvd
Sacramento, CA 95816-7097

Mailing address

1203 Ridgecrest Way
Roseville, CA 95661-5048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191118003266 CA Practitioner - Physical Therapist in Private Practice 6709218472 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT297232CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Oct 7, 2019 Accepting new patients
Sutter Valley Medical Foundation Physical Therapist CurrentSince Oct 7, 2019 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

2702 Low Ct
Fairfield, CA 94534
Phone (707) 432-2600

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2750 Gateway Oaks Dr
Ste 150
Sacramento, CA 95833
Phone (916) 887-7398

1625 Stockton Blvd
Sacramento, CA 95816
Phone (916) 262-9040

1625 Stockton Blvd
Ste 103
Sacramento, CA 95816
Phone (916) 262-9040

Organizations & group practices 4

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": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1083261846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 RIDGECREST WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167097",
            "telephone_number": "916-262-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "JESSIKA",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT297232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.