Bannecker Baxter Woods

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1329453 Issued in TX

Practice address

21301 Kuykendahl Rd Ste B
Spring, TX 77379-2614

Phone

(281) 379-2102

Fax

(281) 379-1760

NPI assigned

Apr 2, 2020

Last updated

May 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kingwood Physical Therapy LTDGroup PAC ID 1759488125, 24 clinicians

Lake Houston Physical Therapy Limited PartnershipGroup PAC ID 5294643680, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lake Houston Physical Therapy Limited Partnership

  • Physical Therapist
  • Humble, TX
  • NPI 1326092099
  Medicare reassignment Care Compare group NPD
• Kingwood Physical Therapy LTD.

  dba Spring-Klein Physical Therapy

  • Physical Therapist
  • Spring, TX
  • NPI 1225185275
  Medicare reassignment Care Compare group
• Cleveland Physical Therapy LTD

  • Physical Therapist
  • Cleveland, TX
  • NPI 1518984392
  Medicare reassignment NPD
• Kingwood Physical Therapy LTD.

  dba Lake Conroe Sports Medicine and Rehabilitation

  • Physical Therapist
  • Montgomery, TX
  • NPI 1992249494
  NPD

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1710516703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21301 KUYKENDAHL RD STE B",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773792614",
            "telephone_number": "281-379-2102",
            "fax_number": "281-379-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21301 KUYKENDAHL RD STE B",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773792614",
            "telephone_number": "281-379-2102",
            "fax_number": "281-379-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "BANNECKER",
        "middle_name": "BAXTER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1329453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1329453",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Woodlands Pain Relief Associates, PLLC
• Woodlands Pharmacy Group, LLC (Woodlands Pharmacy)
• Woodlands Specialty Group PLLC (Woodlands Dental Specialty Group)
• Woodlands Surgery Center, PLLC
• Brittany A Woods Godine
• Carmen Woods, CRNA
• Madison Woods
• Maura Woods
• Woodsprings Dentistry
• Elizabeth Marie Woodward, BCBA

• Physical Therapist in Spring, TX
• Providers in Spring, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.