Active NPI
Todd Noel Wolford, FNP-BC
- Pain Medicine Physician
- Michigan City, IN
National Provider Identifier
1033501937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 71005415A
- Practice address
- 10176 W 400 N Ste B
Michigan City, IN 46360-9009 - Phone
- (219) 809-9839
- Fax
- (219) 809-9841
- NPI assigned
- Mar 2, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71005415A | IN | |
| Pain Medicine Physician | 208VP0000X | 71005415A | IN | Primary |
Addresses
Primary practice location
10176 W 400 N Ste B
Michigan City, IN 46360-9009
Mailing address
10176 W 400 N Ste B
Michigan City, IN 46360-9009
Phone (219) 809-9839
Other practice location 1
6301 University Commons
Suite 100
South Bend, IN 46635-1571
Phone (574) 247-4667
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033501937 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556582400000",
"number": "1033501937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10176 W 400 N STE B",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463609009",
"telephone_number": "219-809-9839",
"fax_number": "219-809-9841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10176 W 400 N STE B",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463609009",
"telephone_number": "219-809-9839",
"fax_number": "219-809-9841"
}
],
"practiceLocations": [
{
"address_1": "6301 University Commons",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466351571",
"country_code": "US",
"telephone_number": "574-247-4667",
"fax_number": "574-271-4458",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLFORD",
"first_name": "TODD",
"middle_name": "NOEL",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-02",
"last_updated": "2019-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71005415A",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "IN",
"license": "71005415A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033501937",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Michigan City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.