Active NPI
Keyder Martin Woodcock
- Peer Specialist
- Huntington, WV
National Provider Identifier
1275265563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 23-9211
- Practice address
- 137 8TH Ave W
Huntington, WV 25701-2510 - Phone
- (304) 747-0639
- NPI assigned
- Jun 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 23-9211 | WV | Primary |
Addresses
Primary practice location
137 8TH Ave W
Huntington, WV 25701-2510
Mailing address
2711 1St Ave Apt 4
Huntington, WV 25702-1358
Phone (681) 286-6033
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23-9211 | WV | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1275265563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2711 1ST AVE APT 4",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257021358",
"telephone_number": "681-286-6033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 8TH AVE W",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257012510",
"telephone_number": "304-747-0639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODCOCK",
"first_name": "KEYDER",
"middle_name": "MARTIN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-27",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WV",
"license": "23-9211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.