Active NPI
Angela Woodruff, PTA
- Health & Wellness Coach
- Lansing, MI
National Provider Identifier
1376930222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- A-3659397
- Practice address
- 2100 E Provincial House Dr
Lansing, MI 48910-4884 - Phone
- (517) 272-4029
- NPI assigned
- Apr 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502003374 | MI | |
| Health & Wellness Coach | 171400000X | A-3659397 | MI | Primary |
Addresses
Primary practice location
2100 E Provincial House Dr
Lansing, MI 48910-4884
Mailing address
2100 E Provincial House Dr
Lansing, MI 48910-4884
Phone (517) 272-4029
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-3659397 | MI | MD | Health & Wellness Coach |
| 5502003374 | MI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700092800000",
"number": "1376930222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 E PROVINCIAL HOUSE DR",
"city": "LANSING",
"state": "MI",
"postal_code": "489104884",
"telephone_number": "517-272-4029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 E PROVINCIAL HOUSE DR",
"city": "LANSING",
"state": "MI",
"postal_code": "489104884",
"telephone_number": "517-272-4029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF",
"first_name": "ANGELA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-17",
"last_updated": "2023-11-16",
"certification_date": "2023-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502003374",
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "MI",
"license": "A-3659397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.