Active NPI
Chad Wade Womack, PT
- Physical Therapist
- Little Rock, AR
National Provider Identifier
1710247747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT2345
- Practice address
- 1601 Aldersgate Road
Little Rock, AR 72205 - Phone
- (501) 687-0851
- NPI assigned
- May 23, 2012
- 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 | PT2345 | AR | Primary |
Addresses
Primary practice location
1601 Aldersgate Road
Little Rock, AR 72205
Mailing address
166 Mountain Valley Dr
Maumelle, AR 72113-6993
Phone (501) 912-5613
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT2345 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450396800000",
"number": "1710247747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 MOUNTAIN VALLEY DR",
"city": "MAUMELLE",
"state": "AR",
"postal_code": "721136993",
"telephone_number": "501-912-5613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 ALDERSGATE ROAD",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72205",
"telephone_number": "501-687-0851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMACK",
"first_name": "CHAD",
"middle_name": "WADE",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-23",
"last_updated": "2015-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT2345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.