Individual provider Active NPI

Paul Brian Woodward, PT

  • Physical Therapist
  • Middleboro, MA
National Provider Identifier
1104925049
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3005 Issued in MA
Practice address
31 W Grove St
Middleboro, MA 02346-1859
Phone
(508) 947-5195
Fax
(508) 947-3447
NPI assigned
Sep 21, 2006
Last updated
Oct 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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 3005 MA Primary

Addresses

Primary practice location

31 W Grove St
Middleboro, MA 02346-1859

Mailing address

31 W Grove St
Middleboro, MA 02346-1859
Phone (508) 947-5195

Other identifiers 1

IdentifierTypeStateIssuer
0308374MedicaidMA

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

LicenseStateTypeSpecialty
3005MAMDPsychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1104925049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W GROVE ST",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461859",
            "telephone_number": "508-947-5195",
            "fax_number": "508-947-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W GROVE ST",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461859",
            "telephone_number": "508-947-5195",
            "fax_number": "508-947-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "PAUL",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "3005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0308374",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleboro, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.