Organization Active NPI

Sole to Soul Podiatry LLC

  • Podiatrist
  • Las Vegas, NV
National Provider Identifier
1982883294
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
9905 Issued in NV
Legal business name
SOLE TO SOUL PODIATRY LLC
Practice address
3815 S Jones Blvd Ste 6
Las Vegas, NV 89103
Phone
(702) 228-1162
Fax
(702) 312-3932
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Dr. Kelley J Woods, DPM
Title
DPM
Phone
(702) 228-1162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 9905 NV Primary

Addresses

Primary practice location

3815 S Jones Blvd Ste 6
Las Vegas, NV 89103

Mailing address

PO Box 30236
Las Vegas, NV 89173-0236
Phone (702) 228-1162

Other identifiers 1

IdentifierTypeStateIssuer
002102010MedicaidNV

National Provider Directory

National Provider Directory

Locations

3815 S Jones Blvd
Ste 6
Las Vegas, NV 89103
Phone (702) 228-1162

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1982883294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30236",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891730236",
            "telephone_number": "702-228-1162",
            "fax_number": "702-312-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 S JONES BLVD STE 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89103",
            "telephone_number": "702-228-1162",
            "fax_number": "702-312-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLE TO SOUL PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "702-228-1162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "9905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002102010",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.