Active NPI
Ian A Wood, ATC
- Athletic Trainer
- Lewisburg, PA
National Provider Identifier
1811927254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT001549A
- Practice address
- 1 Dent Dr
Lewisburg, PA 17837-2005 - Phone
- (570) 577-1056
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 767 | CO | |
| Athletic Trainer | 2255A2300X | 96-039 | WI | |
| Athletic Trainer | 2255A2300X | 36000152A | IN | |
| Athletic Trainer | 2255A2300X | 000153-1 | NY | |
| Athletic Trainer | 2255A2300X | RT001549A | PA | Primary |
Addresses
Primary practice location
1 Dent Dr
Lewisburg, PA 17837-2005
Mailing address
1 Dent Dr
Lewisburg, PA 17837-2005
Phone (570) 577-1056
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 069402484 | Other | BOARD OF CERTIFICATION FOR ATHLETIC TRAINING | |
| RT001549A | Other | PA | STATE ATHLETIC TRAINING LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 767 | CO | MD | Clinical Social Worker |
| 36000152A | IN | MD | Athletic Trainer |
| 000153-1 | NY | MD | Athletic Trainer |
| RT001549A | PA | MD | Athletic Trainer |
| 96-039 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502582400000",
"number": "1811927254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 DENT DR",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178372005",
"telephone_number": "570-577-1056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 DENT DR",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178372005",
"telephone_number": "570-577-1056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "IAN",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2017-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CO",
"license": "767",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "96-039",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36000152A",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "000153-1",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT001549A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION FOR ATHLETIC TRAINING",
"identifier": "069402484",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE ATHLETIC TRAINING LICENSE",
"identifier": "RT001549A",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.