Active NPI
Keith Woodland
- Physical Therapist
- Willard, OH
National Provider Identifier
1538566583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT.011049
- Practice address
- 1510 S Conwell Ave
Willard, OH 44890-9448 - Phone
- (419) 964-5710
- NPI assigned
- Nov 19, 2014
- Last updated
- Nov 19, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT.011049 | OH | Primary |
Addresses
Primary practice location
1510 S Conwell Ave
Willard, OH 44890-9448
Mailing address
195 E County Road 16
Tiffin, OH 44883-8932
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT.011049 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1538566583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 E COUNTY ROAD 16",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448838932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 S CONWELL AVE",
"city": "WILLARD",
"state": "OH",
"postal_code": "448909448",
"telephone_number": "419-964-5710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODLAND",
"first_name": "KEITH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-19",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT.011049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willard, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.