Timothy Gerrard Woodall, MD

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

22243 Issued in SC

Practice address

1563 Healthcare Dr
Rock Hill, SC 29732

Phone

(803) 329-6030

Fax

(803) 329-6035

NPI assigned

Dec 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Dermatology

Education

Medical University of South Carolina College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Palmetto Skin and Laser Center LLCGroup PAC ID 0547247587, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Palmetto Skin and Laser Center LLC

  • Procedural Dermatology Physician
  • Rock Hill, SC
  • NPI 1992726269
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1114902269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 HEALTHCARE DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-329-6030",
            "fax_number": "803-329-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 HEALTHCARE DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-329-6030",
            "fax_number": "803-329-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "TIMOTHY",
        "middle_name": "GERRARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "SC",
            "license": "22243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00162061",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC3336",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jade Witmer, ATC
• Kaitlyn Wojdat, DPT
• Benjamin Wood
• Lawrence Robert Wood, APRN-BC
• Melissa Schwebach Wood, OD
• Mikikia Woodard, APRN
• Alexa Amelia Woods, MD
• Catherine Marie Woody, LPC-A, AADC
• Toni Wooldridge
• Elizabeth Jean Woolridge, FNP

• Procedural Dermatology Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Procedural Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.