Kellie Ann Wood, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

002025-1 Issued in NY

Practice address

242 Port Watson St
Fadden & Associates Physical Therapy PLLC
Cortland, NY 13045

Phone

(607) 758-7212

Fax

(607) 758-3416

NPI assigned

Apr 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fadden & Associates Physical Therapy PLLC

  • Physical Therapist
  • Cortland, NY
  • NPI 1871701177
  NPD (past)

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1285854570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 E MOLLOY RD",
            "city": "MATTYDALE",
            "state": "NY",
            "postal_code": "132111645",
            "telephone_number": "315-455-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 PORT WATSON ST",
            "address_2": "FADDEN & ASSOCIATES PHYSICAL THERAPY PLLC",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "13045",
            "telephone_number": "607-758-7212",
            "fax_number": "607-758-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KELLIE",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "002025-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane E Witt, RN
• Ann Wolak, P.A.
• Lynn T. Wolfson, CRC, SC
• Darcie Jonell Wood Lindley, PT, DPT
• Jamison Robert Wood, LMSW, CASAC
• Patricia S. Wood I, LMHC
• Timothy C. Wood, LMSW
• Jessica Woodard, CRPA
• Ammitai Worob, DC
• Jacqueline Ann Yaman, LMSW

• Physical Therapy Assistant in Cortland, NY
• Providers in Cortland, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.