John Philip Woodall, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

052596 Issued in CT

Practice address

13 Berkshire Rd
Sandy Hook, CT 06482

Phone

(203) 491-2577

Fax

(203) 491-2579

NPI assigned

Feb 28, 2007

Last updated

Jul 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: synergyhealthsolutions.johnwoodall@143047.advancedmd-direct.com

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

• John Woodall, MD LLC

  • Psychiatry Physician
  • Sandy Hook, CT
  • NPI 1467006627
  NPD (past) Authorized official

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1023145745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 DEER HILL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107902",
            "telephone_number": "978-549-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 BERKSHIRE RD",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "06482",
            "telephone_number": "203-491-2577",
            "fax_number": "203-491-2579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Harris Ave",
            "address_purpose": "LOCATION",
            "city": "Lunenburg",
            "state": "MA",
            "postal_code": "014622055",
            "country_code": "US",
            "telephone_number": "978-345-2909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "JOHN",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "73625",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "052596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey A Warner, LCSW
• Wendy Gadwah, LCSW
• Noel Werle, APRN
• Western Connecticut Center for Neurofeedback and Counseling, LLC
• Sarah T Wilkie, LPC
• Joseph Keith Young, O.D.
• Beverly Zeroogian

• Psychiatry Physician in Sandy Hook, CT
• Providers in Sandy Hook, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.