Individual provider Active NPI

Jeffery Wood, M.S., P.T.

  • Physical Therapist
  • Grants Pass, OR
National Provider Identifier
1376527424
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2237 Issued in OR
Practice address
1701 NW Hawthorne Ave
#103
Grants Pass, OR 97526-1257
Phone
(541) 476-2502
Fax
(541) 476-2397
NPI assigned
Dec 2, 2005
Last updated
Mar 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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 2237 OR Primary

Addresses

Primary practice location

1701 NW Hawthorne Ave
#103
Grants Pass, OR 97526-1257

Mailing address

1701 NW Hawthorne Ave
#103
Grants Pass, OR 97526-1257
Phone (541) 476-2502

Other identifiers 1

IdentifierTypeStateIssuer
116582MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102001469 OR Practitioner - Physical Therapist in Private Practice 6800797408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Donato and Wood Consulting IncGroup PAC ID 4587565171, 2 clinicians

Practice addresses (Care Compare)

544 Union Ave
Grants Pass, OR 97527-5544
Phone (541) 955-0940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2237ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Donato and Wood Consulting, Inc Physical Therapist CurrentSince Feb 1, 2001 Accepting new patients
Donato and Wood Consulting Physical Therapist Past Accepting new patients
Donato and Wood Consulting, Inc Physical Therapist Past Accepting new patients
Donato and Wood Consulting Inc Physical Therapist Past Accepting new patients

Locations

1208 Beall Ln
Central Point, OR 97502

114 Molly St
Glendale, OR 97442
Phone (541) 832-2200

1619 NW Hawthorne Ave
Ste 109
Grants Pass, OR 97526
Phone (541) 472-1799

544 Union Ave
Grants Pass, OR 97527
Phone (541) 476-2502

Organizations & group practices 5

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1376527424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "address_2": "#103",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261257",
            "telephone_number": "541-476-2502",
            "fax_number": "541-476-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "address_2": "#103",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261257",
            "telephone_number": "541-476-2502",
            "fax_number": "541-476-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JEFFERY",
        "credential": "M.S., P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116582",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.