NPIMap

Organization Active NPI

Wood & Myers Oral and Maxillofacial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Carlisle, PA
National Provider Identifier
1083067128
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS030386L Issued in PA
Legal business name
WOOD & MYERS ORAL AND MAXILLOFACIAL SURGERY, PC
Practice address
850 Walnut Bottom Rd
Ste 305
Carlisle, PA 17013-3632
Phone
(717) 462-4555
NPI assigned
Jul 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Authorized official

Name
Vanessa Donatucci
Title
Administrative Assistant
Phone
(717) 763-1970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DS030386L PA Primary

Addresses

Primary practice location

850 Walnut Bottom Rd
Ste 305
Carlisle, PA 17013-3632

Mailing address

850 Walnut Bottom Rd
Ste 305
Carlisle, PA 17013-3632

Other names 1

  • Wood & Myers Oral & Maxillofacial Surgeons Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804001542 PA Part B Supplier - Clinic/Group Practice 6901877729 Receives reassigned benefits from 25 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Camp Hill, PA; Harrisburg, PA; Carlisle, PA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wood Myers Oral and Maxillofacial Surgery PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

207 S 32nd St
Camp Hill, PA 17011
Phone (717) 763-1970

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1083067128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 WALNUT BOTTOM RD",
            "address_2": "STE 305",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WALNUT BOTTOM RD",
            "address_2": "STE 305",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133632",
            "telephone_number": "717-462-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD & MYERS ORAL AND MAXILLOFACIAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "DONATUCCI",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "717-763-1970"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS030386L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wood & Myers Oral & Maxillofacial Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.