Lara L Wood, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2196 Issued in KY

Practice address

3810 Springhurst Blvd Ste 200
Louisville, KY 40241-6162

Phone

(502) 583-1749

NPI assigned

May 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Lara Lee Brady Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: lwood@hardinmemorial.gwaydirect.com

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.

• Associates in Dermatology, PLLC

  • Dermatology Physician
  • Louisville, KY
  • NPI 1629083399
  Medicare reassignment
• Ballard Wright, MD, PSC

  • Interventional Pain Medicine Physician
  • Lexington, KY
  • NPI 1740211663
  Medicare reassignment
• Cardiovascular Assoc LTD

  • Cardiovascular Disease Physician
  • Virginia Beach, VA
  • NPI 1023062825
  NPD (past)
• Cardiovascular Associates LTD

  • Cardiovascular Disease Physician
  • Chesapeake, VA
  • NPI 1114971918
  NPD (past)

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1114339173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 SPRINGHURST BLVD STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402416162",
            "telephone_number": "502-583-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 SPRINGHURST BLVD STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402416162",
            "telephone_number": "502-583-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "LARA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-27",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA2196",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100447620",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "BRADY",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Frank S. Wood, MD
• Jennifer Van Lunteren Wood
• John Layne Wood, LMFT
• Kasey Wood, MSN, FNP-BC
• Kevin Lee Wood Jr.
• Leah Wood, MS, BCBA, LBA
• Leslie F Wood, M.D.
• Meredith C Wood, NP
• Robert Donald Wood II, D.D.S.
• Rodger D Wood, CADC

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.