Active NPI
Kristi E Woods, M.D.
- Pediatrics Physician
- Knightdale, NC
National Provider Identifier
1689634610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 200100109
- Practice address
- 4019 Village Park Dr
Knightdale, NC 27545-7044 - Phone
- (919) 266-5059
- Fax
- (919) 266-4309
- NPI assigned
- Mar 24, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 200100109 | NC | Primary |
Addresses
Primary practice location
4019 Village Park Dr
Knightdale, NC 27545-7044
Mailing address
1655 Wake Dr
Suite 101
Wake Forest, NC 27587-4745
Phone (919) 556-4779
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89129RV | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374192000000",
"number": "1689634610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1655 WAKE DR",
"address_2": "SUITE 101",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275874745",
"telephone_number": "919-556-4779",
"fax_number": "919-556-5277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4019 VILLAGE PARK DR",
"city": "KNIGHTDALE",
"state": "NC",
"postal_code": "275457044",
"telephone_number": "919-266-5059",
"fax_number": "919-266-4309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "KRISTI",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-24",
"last_updated": "2013-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "200100109",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89129RV",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Knightdale, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.