Active NPI
Pamela Jean Woodruff
- Occupational Therapist
- Grand Rapids, MI
National Provider Identifier
1639714447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201001692
- Practice address
- 4450 Cascade Rd SE
Grand Rapids, MI 49546-3633 - Phone
- (616) 949-5140
- NPI assigned
- Nov 15, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201001692 | MI | Primary |
Addresses
Primary practice location
4450 Cascade Rd SE
Grand Rapids, MI 49546-3633
Mailing address
5259 Discovery Dr SE
Kentwood, MI 49508-6394
Phone (616) 886-6119
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 |
|---|---|---|---|
| 5201001692 | MI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Porter Hills Home Health West | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Home Health Agency
- Grand Rapids, MI
- NPI 1508845066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573776000000",
"number": "1639714447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5259 DISCOVERY DR SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495086394",
"telephone_number": "616-886-6119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4450 CASCADE RD SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495463633",
"telephone_number": "616-949-5140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF",
"first_name": "PAMELA",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-15",
"last_updated": "2019-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201001692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.