Provider Demographics
NPI:1144228164
Name:WOODS, REBEKAH J (DO)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:J
Last Name:WOODS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4950 NORTON HEALTHCARE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2845
Practice Address - Country:US
Practice Address - Phone:502-394-6460
Practice Address - Fax:502-394-6465
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY026212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY157097OtherSIHO-NNS
KY50065666OtherPASSPORT-NNS
KY64075195Medicaid
50012296OtherPASSPORT 2ND TO MEDICARE
KY000000617818OtherANTHEM
KY000000858393OtherANTHEM-NNS
2772075000OtherPASSPORT ADVANTAGE
KY688594OtherHEALTHLINK
KYP00719575OtherRAILROAD MEDICARE
000000389675OtherANTHEM SR ADVANTAGE
50012296OtherPASSPORT
50012296OtherPASSPORT 2ND TO MEDICARE
KY64075195Medicaid
KY000000858393OtherANTHEM-NNS