Individual provider Active NPI

Jeremy Dustin Woodward, PT, DPT, MS

  • Physical Therapist
  • Paducah, KY
National Provider Identifier
1942462403
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005283 Issued in KY
Practice address
127 Alben Barkley Dr
Suite C
Paducah, KY 42001-4402
Phone
(270) 908-0294
Fax
(270) 908-0296
NPI assigned
Jun 26, 2008
Last updated
Dec 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 005283 KY Primary

Addresses

Primary practice location

127 Alben Barkley Dr
Suite C
Paducah, KY 42001-4402

Mailing address

PO Box 1025
Mayfield, KY 42066-0041
Phone (270) 908-0294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081020000384 KY Practitioner - Physical Therapist in Private Practice 1557429529 Receives reassigned benefits from 5 practitioners
Practice locations: Paducah, KY; Mayfield, KY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

123 Kings Dr
Mayfield, KY 42066-3602
Phone (270) 727-5120

2321 New Holt Rd
Paducah, KY 42001-7404
Phone (270) 908-0294

Merit-based Incentive Payment System (MIPS)

Final score
19.04 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
63.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physical Therapy LLC CurrentSince Apr 5, 2014 Accepting new patients
Commonwealth Health Corporation, Inc. Past Accepting new patients

Locations

127 Alben Barkley Dr
Ste C
Paducah, KY 42001
Phone (270) 779-4945

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1942462403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1025",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420660041",
            "telephone_number": "270-908-0294",
            "fax_number": "270-908-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 ALBEN BARKLEY DR",
            "address_2": "SUITE C",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014402",
            "telephone_number": "270-908-0294",
            "fax_number": "270-908-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "JEREMY",
        "middle_name": "DUSTIN",
        "credential": "PT, DPT, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.