Active NPI
Paul Anthony Woodard, LCSW
- Clinical Social Worker
- Ruther Glen, VA
National Provider Identifier
1023066826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904004439
- Practice address
- 19254 Rogers Clark Blvd
Ruther Glen, VA 22546-4010 - Phone
- (804) 633-9997
- Fax
- (804) 633-7031
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904004439 | VA | Primary |
Addresses
Primary practice location
19254 Rogers Clark Blvd
Ruther Glen, VA 22546-4010
Mailing address
5812 Maybrook CT
Glen Allen, VA 23059-6946
Phone (804) 364-2819
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004945123 | Medicaid | VA | |
| 0006359 | Other | VA | TRICARE |
| 287193 | Other | VA | ANTHEM |
| 291352 | Other | VA | MDIPA |
| 089857 | Other | VA | SENTARA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904004439 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rappahannock Area Community Services Board | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Fredericksburg, VA
- NPI 1790742153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1023066826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5812 MAYBROOK CT",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230596946",
"telephone_number": "804-364-2819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19254 ROGERS CLARK BLVD",
"city": "RUTHER GLEN",
"state": "VA",
"postal_code": "225464010",
"telephone_number": "804-633-9997",
"fax_number": "804-633-7031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODARD",
"first_name": "PAUL",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904004439",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004945123",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "0006359",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "287193",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA",
"identifier": "291352",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "089857",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ruther Glen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.