Individual provider Active NPI

Willeen Woodall, COTA

  • Skilled Nursing Facility
  • Palm Harbor, FL
National Provider Identifier
1417481813
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
OTA15811 Issued in FL
Practice address
31790 US Highway 19 N
Unit 252
Palm Harbor, FL 34684-3729
Phone
(850) 843-5837
NPI assigned
Apr 12, 2017
Last updated
Apr 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X OTA15811 FL Primary

Addresses

Primary practice location

31790 US Highway 19 N
Unit 252
Palm Harbor, FL 34684-3729

Mailing address

31790 US Highway 19 N
Unit 252
Palm Harbor, FL 34684-3729
Phone (850) 843-5837

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA15811FLMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1417481813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31790 US HIGHWAY 19 N",
            "address_2": "UNIT 252",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843729",
            "telephone_number": "850-843-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31790 US HIGHWAY 19 N",
            "address_2": "UNIT 252",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843729",
            "telephone_number": "850-843-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "WILLEEN",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "OTA15811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.