Active NPI
Sole to Soul Podiatry LLC
- Podiatrist
- Las Vegas, NV
National Provider Identifier
1982883294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 9905
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002102010 | Medicaid | NV |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Podiatrist
- Las Vegas, NV
- NPI 1720179716
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.