Organization Active NPI

Woodard Hypnosis and Research, Inc.

  • Clinical Psychologist
  • Milford, NH
National Provider Identifier
1053321166
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1082 Issued in NH
Legal business name
WOODARD HYPNOSIS AND RESEARCH, INC.
Practice address
15B Lincoln Street
Milford, NH 03055
Phone
(603) 673-2582
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Authorized official

Name
Dr. Fredrick James Woodard, PHD
Title
Owner/Clinical Director
Phone
(603) 673-2582

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 1082 NH
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 1082 NH Primary

Addresses

Primary practice location

15B Lincoln Street
Milford, NH 03055

Mailing address

PO Box 874
Milford, NH 03055-0874
Phone (603) 673-2582

Other identifiers 1

IdentifierTypeStateIssuer
3073391MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050829000713 NH Part B Supplier - Clinic/Group Practice 4981635091 Practice locations: Milford, NH

National Provider Directory

National Provider Directory

Locations

33 Putnam St
#B
Milford, NH 03055
Phone (603) 673-2582

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1053321166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 874",
            "city": "MILFORD",
            "state": "NH",
            "postal_code": "030550874",
            "telephone_number": "603-673-2582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15B LINCOLN STREET",
            "city": "MILFORD",
            "state": "NH",
            "postal_code": "03055",
            "telephone_number": "603-673-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODARD HYPNOSIS AND RESEARCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "603-673-2582",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NH",
            "license": "1082",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3073391",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.