Active NPI
Christy King Woodruff, OTRL
- Pediatric Occupational Therapist
- Greenville, NC
National Provider Identifier
1710949151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 2627
- Practice address
- 2880 W 5TH St
Greenville, NC 27834-6166 - Phone
- (252) 717-9668
- Fax
- (252) 321-0484
- NPI assigned
- Apr 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 2627 | NC | Primary |
| Occupational Therapist | 225X00000X | 2627 | NC |
Addresses
Primary practice location
2880 W 5TH St
Greenville, NC 27834-6166
Mailing address
2880 W 5TH St
Greenville, NC 27834-6166
Phone (252) 717-9668
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7349358 | Medicaid | NC | |
| 49358 | Other | NC | BLUE CROSS BLUE SHIELD 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2627 | NC | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| OT Works | Single Specialty | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616630400000",
"number": "1710949151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2880 W 5TH ST",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278346166",
"telephone_number": "252-717-9668",
"fax_number": "252-321-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2880 W 5TH ST",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278346166",
"telephone_number": "252-717-9668",
"fax_number": "252-321-0484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF",
"first_name": "CHRISTY",
"middle_name": "KING",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-03",
"last_updated": "2021-03-25",
"certification_date": "2021-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NC",
"license": "2627",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NC",
"license": "2627",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7349358",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD NC",
"identifier": "49358",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.