Gerald R Woodard DO PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS4717 Issued in FL

Legal business name

GERALD R WOODARD DO PA

Practice address

3512 S Atlantic Ave
Daytona Beach Shores, FL 32118-7639

Phone

(386) 767-9544

Fax

(386) 756-0501

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Gerald R WoodardNPI 1700877388

Title

President

Phone

(386) 767-9544

Specialties & licenses 1

Addresses

Other names 1

• SHORES MEDICAL CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 8

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

• Gerald R Woodard, D.O.

  • Family Medicine Physician
  • Daytona Beach Shores, FL
  • NPI 1700877388
  Medicare reassignment Care Compare group Authorized official
• Lauren A Girard, DO

  • Family Medicine Physician
  • Daytona Beach Shores, FL
  • NPI 1346690484
  Medicare reassignment Care Compare group
• Tara James, FNP

  • Family Nurse Practitioner
  • Daytona Beach Shores, FL
  • NPI 1518433804
  Medicare reassignment Care Compare group
• Holly Mulvey

  • Adult Health Nurse Practitioner
  • Port Orange, FL
  • NPI 1639534159
  Medicare reassignment Care Compare group
• Meagan Ann Burgess, APRN, FNP-BC

  • Family Nurse Practitioner
  • Lake Mary, FL
  • NPI 1891261863
  Medicare reassignment
• Angela Marie Campbell, NP-C

  • Family Nurse Practitioner
  • Ponce Inlet, FL
  • NPI 1811265572
  Medicare reassignment
• Diane Gellermann, ARNP

  • Nurse Practitioner
  • Port Orange, FL
  • NPI 1265891816
  Medicare reassignment
• Adrianna Andrews Weber, PA-C

  • Physician Assistant
  • South Daytona, FL
  • NPI 1801343702
  Medicare reassignment

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1114111440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 S ATLANTIC AVE",
            "city": "DAYTONA BEACH SHORES",
            "state": "FL",
            "postal_code": "321187639",
            "telephone_number": "386-767-9544",
            "fax_number": "386-756-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 S ATLANTIC AVE",
            "city": "DAYTONA BEACH SHORES",
            "state": "FL",
            "postal_code": "321187639",
            "telephone_number": "386-767-9544",
            "fax_number": "386-756-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD R WOODARD DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-767-9544"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS4717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHORES MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• East Central Florida Outpatient Imaging, LLC
• Elite Aesthetics, LLC
• James Evensen, MA BCBA
• Bettina Fulford, ARNP
• David Gaughan, M,D.
• Gerald R Woodard DO PA
• Lauren A Girard, DO
• Jamera F Givens
• Hassan Alkhatib MD PA
• Heritage Waterside

• Family Medicine Physician in Daytona Beach Shores, FL
• Providers in Daytona Beach Shores, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.