Active NPI
Brendin Wood, PT, DPT
- Physical Therapist
- Kirtland Afb, NM
National Provider Identifier
1831836931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05014584A
- Practice address
- 2050A 2ND St SE
Kirtland Afb, NM 87117-2035 - Phone
- (816) 351-1801
- NPI assigned
- May 19, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-8117 | ID | |
| Physical Therapist | 225100000X | 05014584A | IN | Primary |
Addresses
Primary practice location
2050A 2ND St SE
Kirtland Afb, NM 87117-2035
Mailing address
8 SE Hilltop Terrace Rd
Saint Joseph, MO 64507-7911
Phone (816) 351-1801
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 |
|---|---|---|---|
| PT-8117 | ID | MD | Physical Therapist |
| 05014584A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679529600000",
"number": "1831836931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 SE HILLTOP TERRACE RD",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "645077911",
"telephone_number": "816-351-1801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050A 2ND ST SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871172035",
"telephone_number": "816-351-1801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "BRENDIN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-19",
"last_updated": "2023-03-23",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-8117",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05014584A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirtland Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.