Dr Robert Woodruff DPM PA

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

80102 Issued in MS

Legal business name

DR ROBERT WOODRUFF DPM PA

Practice address

1055 Hubb Rd
Bolton, MS 39041-8500

Phone

(601) 506-7400

NPI assigned

Feb 20, 2008

Last updated

Sep 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Woodruff, DPMNPI 1336220177

Title

Ceo

Phone

(601) 506-7400

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 1

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.

• Robert Kelvin Woodruff, D.P.M., P.A.

  • Foot Surgery Podiatrist
  • Jackson, MS
  • NPI 1336220177
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1083882385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 HUBB RD",
            "city": "BOLTON",
            "state": "MS",
            "postal_code": "390418500",
            "telephone_number": "601-506-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 HUBB RD",
            "city": "BOLTON",
            "state": "MS",
            "postal_code": "390418500",
            "telephone_number": "601-506-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ROBERT WOODRUFF DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-506-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MS",
            "license": "80102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110072",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "podiatryassociat@aol.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1055 Hubb Rd",
            "city": "Bolton",
            "state": "MS",
            "country_code": "US",
            "postal_code": "390418500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "podiatryassociat@aol.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1055 Hubb Rd",
            "city": "Bolton",
            "state": "MS",
            "country_code": "US",
            "postal_code": "390418500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bolton Edwards Elementary Middle School
• Robin L Bolton, LPC
• Coleman A. Boyd, M.D.
• Caring Hands Touch of Care
• Central Mississippi Civic Improvement Association, Inc (Jackson Hinds Comprehensive Health Center)
• Janet Gray
• Health Wellness Promotion LLC (Bolton Family Clinic)
• Lisa Byrd Healthcare Inc (Bolton Family Clinic)
• Lisa Byrd Healthcare Inc (Bolton Family Clinic)
• Jean Pennington Marks, GNP-BC

• Foot Surgery Podiatrist in Bolton, MS
• Providers in Bolton, MS by specialty
• Foot Surgery Podiatrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.