Individual provider Active NPI

Kaitlin Elizabeth Wood, PA-C

  • Physician Assistant
  • Moore, OK
National Provider Identifier
1104440619
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006692 Issued in CO
Practice address
2900 S Telephone Rd Ste 250
Moore, OK 73160-2969
Phone
(405) 237-7500
Fax
(405) 237-7512
NPI assigned
May 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA.0006692 CO Primary

Addresses

Primary practice location

2900 S Telephone Rd Ste 250
Moore, OK 73160-2969

Mailing address

2900 S Telephone Rd Ste 250
Moore, OK 73160-2969
Phone (405) 237-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210716000971 CO Practitioner - Physician Assistant 5496174872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Colorado, PC Physician Assistant CurrentSince Aug 1, 2021 Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients

Locations

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

Organizations & group practices 5

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": "1590883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1104440619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD STE 250",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602969",
            "telephone_number": "405-237-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD STE 250",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602969",
            "telephone_number": "405-237-7500",
            "fax_number": "405-237-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KAITLIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-31",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.