Active NPI
Joshua David Wood, PA-C
- Physician Assistant
- Kirtland Afb, NM
National Provider Identifier
1477958643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2050A 2ND St SE
Kirtland Afb, NM 87117-5901 - Phone
- (720) 695-7889
- NPI assigned
- Oct 29, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
2050A 2ND St SE
Kirtland Afb, NM 87117-5901
Mailing address
6330 Aragon Way Apt 102
Fort Myers, FL 33966-4784
Phone (334) 464-2433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154545440 | Other | TX | AIR FORCE TRICARE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1477958643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6330 ARAGON WAY APT 102",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339664784",
"telephone_number": "334-464-2433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050A 2ND ST SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871175901",
"telephone_number": "720-695-7889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "JOSHUA",
"middle_name": "DAVID",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-29",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AIR FORCE TRICARE",
"identifier": "1154545440",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirtland Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.