Individual provider Active NPI

Kenneth Woodrow, M.D.

  • Psychiatry Physician
  • Menlo Park, CA
National Provider Identifier
1730187154
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G16718 Issued in CA
Practice address
1225 Crane St
#106
Menlo Park, CA 94025-4257
Phone
(650) 324-1500
NPI assigned
Jul 9, 2005
Sex
Male
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
Psychiatry Physician 2084P0800X G16718 CA Primary

Addresses

Primary practice location

1225 Crane St
#106
Menlo Park, CA 94025-4257

Mailing address

1225 Crane St
#106
Menlo Park, CA 94025-4257
Phone (650) 324-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 8, 2013 through May 8, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16718CAMDFamily Medicine Physician
G16718CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730187154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CRANE ST",
            "address_2": "#106",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254257",
            "telephone_number": "650-324-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CRANE ST",
            "address_2": "#106",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254257",
            "telephone_number": "650-324-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODROW",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G16718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

Verify at the official NPI Registry.