Veronica Woodson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3951 Issued in MS

Practice address

1650 Lelia Dr Ste 105
Jackson, MS 39216-4864

Phone

(601) 790-0725

NPI assigned

Aug 21, 2018

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

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Revive Pelvic Health & Physical Therapy LLC

  dba Revive Pelvic Health and Physical Therapy

  • Physical Therapy Clinic/Center
  • Clinton, MS
  • NPI 1689266009
  Medicare reassignment NPD

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1508346222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 VICTORIA LN",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LELIA DR STE 105",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164864",
            "telephone_number": "601-790-0725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Chadwick Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392043404",
            "country_code": "US",
            "telephone_number": "601-376-1000 x2155",
            "fax_number": "601-376-2960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODSON",
        "first_name": "VERONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Dwayne Woods, RD, CHES
• Tanielle Woods
• Thomas Woods, PHARM. D.
• William Carl Woods III, MSN
• James Randall Woodson III, D.M.D.
• Amy Woodward, MCD, CCC-SLP
• Frances Christine Woodward, PHHNP, FNP
• Louann Woodward, M.D.
• John R Wooley, MD
• Luke Wooten, MD

• Physical Therapist in Jackson, MS
• Providers in Jackson, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.