CASEY T WOODS (NPI# 1063738557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063738557 |
| Entity Type | Individual |
| Full Name | CASEY T WOODS |
| Credential | P.A.-C |
| Practice Address |
6110 Dr Martin Luther King Jr St N St Petersburg FL 33703-1142 |
| Mailing Address |
4200 N Armenia Ave Ste 1 Tampa FL 33607-6451 |
| Practice Telephone | 7278213600 |
| Practice Fax Number | 7278213611 |
| Mailing Telephone | 8138774811 |
| Mailing Fax Number | 8138728978 |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2019-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9105335 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9105335 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6110 DR MARTIN LUTHER KING JR ST N |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33703-1142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841240462 | Margaret Ann Kelleher | Dermatology | 6110 Dr Martin Luther King Jr St N, St Petersburg, FL 33703-1142 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376150276 | Stephanie Gayle Barnes | Rehabilitation Practitioner | 610 47th Ave N, St Petersburg, FL 33703 | 2020-09-25 |
| 1366945099 | St. Petersburg Free Clinic | General Practice | 5501 - 4th Street North, St. Petersburg, FL 33703 | 2018-03-08 |
| 1306381363 | Dominique Timothee | Behavioral Analyst | 4301 16th Street N, St Petersburg, FL 33703 | 2016-12-30 |
| 1962849455 | Bobbie Vaughn | Behavioral Analyst | 880 6th St. South, St. Petersburg, FL 33703 | 2013-05-24 |
| 1255672796 | Mary Paige Bourbeau | Nurse Practitioner | 5500 9th St N., St Petersburg, FL 33703 | 2013-03-07 |
| 1437435237 | Lynn Bonner-nelson | Counselor | 6161 Dr. Mlk Jr Street N. #204, Saint Petersburg, FL 33703 | 2011-10-25 |
| 1245545953 | Patricia Reynolds | Speech-Language Pathologist | 3950 3rd Street North, Suite D, Community Rehab Associates, St. Petersburg, Fl, FL 33703 | 2010-08-18 |
| 1326367145 | Sigurd T Rutkis | Occupational Therapist | 3835 1st Street Northeast, St. Petersburg, FL 33703 | 2010-05-18 |
| 1922338136 | Christy Carr | Mechanotherapist | 5560 Kelly Dr N, Saint Petersburg, FL 33703 | 2010-01-11 |
| 1871730317 | Ronald H Copenhaver Dmd Pa | Dentist | 4338 1st Street N, Suite C, St. Petersburg, FL 33703 | 2009-01-20 |
| Find all providers in zip 33703 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366726994 | Coley Lauren Westerberg | Physician Assistant | 1033 Martin Luther King Street North, Suite 108, St Petersburg, FL 33701 | 2011-09-30 |
| 1669569687 | Lynn L Lybrand | Physician Assistant | 5398 Park Street North, St Petersburg, FL 33709 | 2006-10-10 |
| 1225129646 | Gerald P Marshbanks | Physician Assistant | 1301 Beach Dr Se, St Petersburg, FL 33701-5621 | 2006-09-28 |
| 1356390785 | Christina M. Burke | Physician Assistant | 3251 3rd Ave N Rm 125, St Petersburg, FL 33713-8549 | 2006-05-10 |
| 1831185685 | Tiffani Ondrea Mcgee | Physician Assistant | 560 Jackson St N, Suite 100, St Petersburg, FL 33705-1405 | 2005-09-26 |
| 1790283331 | William Travis Hupp | Physician Assistant | 4600 4th St N, St Petersburg, FL 33703 | 2018-01-29 |
| 1649712274 | Raymundo Gamboa Jacinto | Physician Assistant | 501 6th Ave S, St Petersburg, FL 33701 | 2016-11-14 |
| 1215313671 | Emily Mattei Godfrey | Physician Assistant | 501 6th Ave S, St Petersburg, FL 33701-4634 | 2015-08-07 |
| 1265824817 | Crystal Diana Thomas | Physician Assistant | 1839 Central Ave, St Petersburg, FL 33713-8900 | 2015-02-19 |
| 1477998904 | Alyssa Perry | Physician Assistant | 560 Jackson St N, Suite 100, St Petersburg, FL 33705-1449 | 2013-05-10 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33703 |
Please comment or provide details below to improve the information on CASEY T WOODS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.