Individual provider Active NPI

John Hiram Woodruff, M.D.

  • Emergency Medicine Physician
  • Atlanta, GA
National Provider Identifier
1063655769
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
066442 Issued in GA
Practice address
1968 Peachtree Rd NW
Atlanta, GA 30309
Phone
(404) 605-5000
NPI assigned
Apr 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2012-01106 NC
Emergency Medicine Physician 207P00000X 066442 GA Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Atlanta, GA 30309

Mailing address

2727 Paces Ferry Rd SE Ste 1-1100
Atlanta, GA 30339-6151
Phone (470) 271-3418

Other identifiers 1

IdentifierTypeStateIssuer
5920643MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.woodruff@trhs.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150917001251 GA Practitioner - Emergency Medicine 8123274743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Emory University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Ed Professionals LLCGroup PAC ID 1759543176, 37 clinicians

Practice addresses (Care Compare)

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-2800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
066442GAMDEmergency Medicine Physician
2012-01106NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc. CurrentSince Jan 1, 2016 Accepting new patients
Tift Regional Health System Inc CurrentSince Jan 1, 2016 Accepting new patients
Piedmont Ed Professionals, LLC Emergency Medicine CurrentSince Jul 16, 2018 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 15, 2015 Accepting new patients
Wake Forest University Health Sciences Emergency Medicine Past Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374

1622 Madison Ave
Tifton, GA 31794
Phone (229) 387-8061

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

Interoperability endpoints

  • Direct secure messaging: john.woodruff@trhs.cernerdirect.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1063655769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 PACES FERRY RD SE STE 1-1100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396151",
            "telephone_number": "470-271-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-605-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "JOHN",
        "middle_name": "HIRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2012-01106",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "066442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920643",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.woodruff@trhs.cernerdirect.com",
            "affiliation": "N",
            "address_1": "901 18th St E",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317943648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.