Individual provider Active NPI

Natasha Celest Woodham, APRN

  • Family Nurse Practitioner
  • Lynn Haven, FL
National Provider Identifier
1073930947
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9244792 Issued in FL
Practice address
1612 Tennessee Ave Ste 300
Lynn Haven, FL 32444-3653
Phone
(850) 872-0774
NPI assigned
Mar 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9244792 FL Primary

Addresses

Primary practice location

1612 Tennessee Ave Ste 300
Lynn Haven, FL 32444-3653

Mailing address

5819 Frank Hough Rd
Panama City, FL 32404-3062
Phone (850) 896-1285

Other practice location 1

210 E 11th St
Panama City, FL 32401-2939
Phone (850) 872-7760 ext. 110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150818003407 FL Practitioner - Nurse Practitioner 3375763832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Woodham Family Medical LLCGroup PAC ID 4688989874, 2 clinicians

Practice addresses (Care Compare)

1621 Tennessee Ave
Suite 300
Lynn Haven, FL 32444-3604
Phone (850) 872-0774

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Organizations & group practices 1

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 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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1073930947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 FRANK HOUGH RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324043062",
            "telephone_number": "850-896-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 TENNESSEE AVE STE 300",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443653",
            "telephone_number": "850-872-0774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 E 11th St",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324012939",
            "country_code": "US",
            "telephone_number": "850-872-7760 x110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODHAM",
        "first_name": "NATASHA",
        "middle_name": "CELEST",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9244792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn Haven, FL

Sources for this page

Verify at the official NPI Registry.