Penelope Woodward, OTR

Primary specialty

ContractorTaxonomy code 171W00000X

License

0031319 Issued in CO

Practice address

490 N Diamond Ave
Canon City, CO 81212-2521

Phone

(719) 276-6174

Fax

(719) 276-6199

NPI assigned

Jul 18, 2013

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

Other identifiers 1

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": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1760824783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S 8TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124906",
            "telephone_number": "719-207-0994",
            "fax_number": "719-276-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 N DIAMOND AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122521",
            "telephone_number": "719-276-6174",
            "fax_number": "719-276-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "PENELOPE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "CO",
            "license": "0031319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95138340",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Contractor in Canon City, CO
• Providers in Canon City, CO by specialty
• Contractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.