NPIMap

Individual provider Active NPI

Woodrow Wilson Brand III, MD

  • Surgery Physician
  • Amory, MS
National Provider Identifier
1053492645
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
12093 Issued in MS
Practice address
806 Earl Frye Blvd
Amory, MS 38821
Phone
(662) 256-8479
Fax
(662) 256-1177
NPI assigned
Oct 18, 2006
Last updated
Apr 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 12093 MS Primary

Addresses

Primary practice location

806 Earl Frye Blvd
Amory, MS 38821

Mailing address

10996 Four Seasons PL
Ste 100a
Crown Point, IN 46307-8685
Phone (662) 256-8479

Other identifiers 2

IdentifierTypeStateIssuer
009306530MedicaidAL
0111887MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100730000642 MS Practitioner - General Surgery 6901939727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Mississippi School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clay County Medical CorporationGroup PAC ID 4789649609, 36 clinicians

Practice addresses (Care Compare)

111 Medical Ctr Dr
West Point, MS 39773-0428
Phone (662) 494-1509

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy41
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux19
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Oct 1, 2017 Accepting new patients
Clay County Medical Corporation CurrentSince Mar 1, 2020 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Clay County Medical Corporation Current Accepting new patients
Clay County Medical Corporation Current Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Oct 1, 2017 Accepting new patients
Clay County Medical Corporation Surgery CurrentSince Mar 1, 2020 Accepting new patients
Clay County Medical Corporation Past Accepting new patients

Locations

10996 Four Seasons Pl
Ste 100A
Crown Point, IN 46307
Phone (219) 213-2380

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

502 S Chestnut St
Aberdeen, MS 39730
Phone (662) 319-8844

40128 Hamilton Rd
Hamilton, MS 39746
Phone (662) 343-5129

111 Medical Center Dr
West Point, MS 39773
Phone (662) 327-4432

150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321

Interoperability endpoints

  • Direct secure messaging: woodrowbrand@nmhs.medalliesdirect.net
  • Direct secure messaging: woody_brand_md_surgeon@yourcarecommunity.org

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1053492645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10996 FOUR SEASONS PL",
            "address_2": "STE 100A",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078685",
            "telephone_number": "662-256-8479",
            "fax_number": "662-256-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 EARL FRYE BLVD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "38821",
            "telephone_number": "662-256-8479",
            "fax_number": "662-256-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "WOODROW",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "12093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009306530",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0111887",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amory, MS

Sources for this page

Verify at the official NPI Registry.