Tina Denise Wofford, SAC

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

177597 Issued in TX

Practice address

925 Santa Fe Dr
Suite 107
Weatherford, TX 76086-5866

Phone

(940) 328-3119

Fax

(817) 599-6559

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Andrew Scott Walker

  • Specialist
  • Weatherford, TX
  • NPI 1972668564
  NPD (past)
• Timberland Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Cedar Park, TX
  • NPI 1023790045
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013127083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SANTA FE DR",
            "address_2": "SUITE 107",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865866",
            "telephone_number": "940-328-3119",
            "fax_number": "817-599-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SANTA FE DR",
            "address_2": "SUITE 107",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865866",
            "telephone_number": "940-328-3119",
            "fax_number": "817-599-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOFFORD",
        "first_name": "TINA",
        "middle_name": "DENISE",
        "credential": "SAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "177597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST ASSISTANT CERT.",
            "identifier": "04-218",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Ann Wilson, P.A.
• Winnie-Stowell Hospital District
• Anne Greer Winquist, HIS
• Mary Beth Winton, N.P.
• Madison R Witt, SLP
• Esther Wolf, CHIROPRACTOR
• Joel S Wolinsky, M.D.
• Stacey Wood, RDLD
• Steven C Wood, DDS, MS
• Katelyn Woodall

• Licensed Vocational Nurse in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.