Krystal Anne Wood, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007416 Issued in VA

Practice address

605 E Holly St Apt 206
Boise, ID 83712-7882

Phone

(717) 919-5479

NPI assigned

Apr 27, 2020

Last updated

Jan 25, 2024By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Branch Medical Clinic Nas Pensacola

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Pensacola, FL
  • NPI 1952501488
  NPD (past)

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1376164723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 TURNER ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325085211",
            "telephone_number": "850-452-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E HOLLY ST APT 206",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837127882",
            "telephone_number": "717-919-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KRYSTAL",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Bingham Wood, PA-C
• David W Wood, M.D.
• Ian Michael Wood, PHARM D
• Janet L Wood, NP
• Julia Claire Wood, LCPC
• Lisa Wood, RRT
• Nicholas Jordan Wood, PHARMD
• Rachel Nicole Wood, MS, CCC-SLP
• Shawn Michael Arana Wood, DPT
• Kevin Woodall, SLP

• Clinical Psychologist in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.