Kelly Marie Wood, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502003518 Issued in MI

Practice address

933 3 Mile Rd NW Ste 110
Grand Rapids, MI 49544-1673

Phone

(616) 785-2619

Fax

(616) 785-2623

NPI assigned

May 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1750640801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 COBBLEFIELD CIR SE APT 10",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167672",
            "telephone_number": "231-557-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 3 MILE RD NW STE 110",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495441673",
            "telephone_number": "616-785-2619",
            "fax_number": "616-785-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502003518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Lynn Wood, LMSW
• Gabriel Patrick Wood
• James C Wood, LMSW, LMFT
• Jessica Wood
• Joel Tyler Wood, MD
• Megan Allena Wood
• Richard E Wood, MD
• Shelli Marie Wood, D.C.
• Taylor Wood
• Taylor Caitlin Wood, COTA/L

• Physical Therapy Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.