Active NPI
Kathleen A Wooten, O.D.
- Optometrist
- Phoenix, AZ
National Provider Identifier
1386743532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1609
- Practice address
- Phoenix Indian Medical Center
4212 N. 16TH Street
Phoenix, AZ 85016-5319 - Phone
- (602) 263-1200
- NPI assigned
- Sep 22, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1609 | KS | Primary |
Addresses
Primary practice location
Phoenix Indian Medical Center
4212 N. 16TH Street
Phoenix, AZ 85016-5319
Mailing address
PO Box 31001-0698
Pasadena, CA 91110-0698
Phone (602) 263-1200
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 |
|---|---|---|---|
| 1609 | KS | MD | Optometrist |
| 196 | AK | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ton San Xavier Health Center | Past | Accepting new patients | |
| Ton Santa Rosa Health Center | Past | Accepting new patients | |
| Ton Sells Hospital | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Tucson, AZ
- NPI 1518905793
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Sells, AZ
- NPI 1326080425
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Sells, AZ
- NPI 1699717785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1386743532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31001-0698",
"city": "PASADENA",
"state": "CA",
"postal_code": "911100698",
"telephone_number": "602-263-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PHOENIX INDIAN MEDICAL CENTER",
"address_2": "4212 N. 16TH STREET",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850165319",
"telephone_number": "602-263-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOTEN",
"first_name": "KATHLEEN",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "1609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.