Individual provider Active NPI

Kathryn L Wood, DPT

  • Physical Therapist
  • Fenton, MI
National Provider Identifier
1679645964
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011443 Issued in MI
Practice address
400 Rounds Dr
Fenton, MI 48430-1724
Phone
(810) 750-1996
NPI assigned
Nov 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501011443 MI Primary

Addresses

Primary practice location

400 Rounds Dr
Fenton, MI 48430-1724

Mailing address

400 Rounds Dr
Fenton, MI 48430-1724
Phone (810) 750-1996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000497 MI Practitioner - Physical Therapist in Private Practice 5991768491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

319 S Bridge St
Linden, MI 48451-8966
Phone (810) 735-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501011443MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince Nov 1, 2017 Accepting new patients

Locations

740 W Grand River Ave
Brighton, MI 48116
Phone (810) 227-3588

400 Rounds Dr
Fenton, MI 48430
Phone (810) 629-0530

7559 36th Ave
Hudsonville, MI 49426
Phone (616) 369-0440

3751 S State Rd
Ionia, MI 48846
Phone (616) 522-0066

319 S Bridge St
Linden, MI 48451
Phone (810) 735-0010

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

135 S Milford Rd
Ste 307
Milford, MI 48381

1764 S Ortonville Rd
Ortonville, MI 48462
Phone (248) 793-5730

204 W Upton Ave
Reed City, MI 49677
Phone (231) 465-4289

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679645964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ROUNDS DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301724",
            "telephone_number": "810-750-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ROUNDS DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301724",
            "telephone_number": "810-750-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.