NPIMap

Organization Active NPI

John D. Woody, MD, PA

  • Pain Medicine (Anesthesiology) Physician
  • Lakeland, FL
National Provider Identifier
1063465524
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
JOHN D. WOODY, MD, PA
Practice address
3340 Lakeland Hills Blvd
Lakeland, FL 33805-1974
Phone
(317) 614-9863
Fax
(844) 876-0873
NPI assigned
May 18, 2006
Last updated
Oct 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Authorized official

Name
Dr. John Woody, MDNPI 1972559847
Title
MD/President
Phone
(317) 614-9863

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
Pain Medicine (Anesthesiology) Physician 207LP2900X FL Primary

Addresses

Primary practice location

3340 Lakeland Hills Blvd
Lakeland, FL 33805-1974

Mailing address

PO Box 863258
Orlando, FL 32886-3258
Phone (855) 496-3581

Other identifiers 3

IdentifierTypeStateIssuer
273664100MedicaidFL
38562OtherFLBLUE CROSS BLUE SHIELD
DD6609OtherFLRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050808000181 FL Part B Supplier - Clinic/Group Practice 4789613076 Receives reassigned benefits from 8 practitioners
Practice locations: Lakeland, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1063465524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863258",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863258",
            "telephone_number": "855-496-3581",
            "fax_number": "844-876-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338051974",
            "telephone_number": "317-614-9863",
            "fax_number": "844-876-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN D. WOODY, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "WOODY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MD/PRESIDENT",
        "authorized_official_telephone_number": "317-614-9863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273664100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "38562",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD6609",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.