Staci Celeste Woods, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

RPT 1598 Issued in ID

Practice address

457 S Fitness PL
Suite 100
Eagle, ID 83616-6568

Phone

(208) 939-3332

Fax

(208) 939-3338

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Staci Celeste Largent Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497842926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 S FITNESS PL",
            "address_2": "SUITE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166568",
            "telephone_number": "208-939-3332",
            "fax_number": "208-939-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 S FITNESS PL",
            "address_2": "SUITE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166568",
            "telephone_number": "208-939-3332",
            "fax_number": "208-939-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "STACI",
        "middle_name": "CELESTE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "RPT 1598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "TC977",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010150739",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "LARGENT",
            "middle_name": "CELESTE",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Noreen A. Womack, MD
• Allen Wong, MD
• Brian Wong
• Cynthia Woodhouse, MPT
• Natalie Woods
• Todd R Woodward, PA-C
• Vicki L Wooll, MD MPH
• Jon Robert Worbets, LPCC
• Morgan Would
• Ashley Wright, MA, CCC-SLP

• Physical Therapist in Eagle, ID
• Providers in Eagle, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.