NPIMap

Organization Active NPI

Linda Woodson Dermatology, a Professional Corporation

  • Dermatology Physician
  • Las Vegas, NV
National Provider Identifier
1023360625
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
7012 Issued in NV
Legal business name
LINDA WOODSON DERMATOLOGY, A PROFESSIONAL CORPORATION
Practice address
2800 N Tenaya Way Ste 203
Las Vegas, NV 89128-1100
Phone
(702) 561-8741
Fax
(702) 307-5480
NPI assigned
Oct 5, 2012
Last updated
Oct 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Authorized official

Name
Dr. Linda S Woodson, M.D.NPI 1972682664
Title
President
Phone
(702) 561-8741

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 7012 NV Primary

Addresses

Primary practice location

2800 N Tenaya Way Ste 203
Las Vegas, NV 89128-1100

Mailing address

2800 N Tenaya Way Ste 203
Las Vegas, NV 89128-1100
Phone (702) 561-8741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130208000037 NV Part B Supplier - Clinic/Group Practice 8224282751 Receives reassigned benefits from 10 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1023360625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N TENAYA WAY STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281100",
            "telephone_number": "702-561-8741",
            "fax_number": "702-307-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N TENAYA WAY STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281100",
            "telephone_number": "702-561-8741",
            "fax_number": "702-307-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA WOODSON DERMATOLOGY, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "WOODSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-561-8741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NV",
            "license": "7012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.