Individual provider Active NPI

Kristin E Woodard, D.O.

  • Family Medicine Physician
  • Sylvania, OH
National Provider Identifier
1114921095
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-00-5713 Issued in OH
Practice address
7640 Sylvania Ave
Suite K
Sylvania, OH 43560-9729
Phone
(419) 517-1001
Fax
(419) 517-1021
NPI assigned
Jun 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-00-5713 OH Primary

Addresses

Primary practice location

7640 Sylvania Ave
Suite K
Sylvania, OH 43560-9729

Mailing address

7640 Sylvania Ave
Suite K
Sylvania, OH 43560-9729
Phone (419) 517-1001

Other identifiers 3

IdentifierTypeStateIssuer
P00038728OtherRAILROAD MEDICARE
2420633MedicaidOH
4524124MedicaidMI

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100507000738 OH Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 8022146299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Ohio University, College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sylvan Lakes Family Physicians LTDGroup PAC ID 7416928460, 4 clinicians

Practice addresses (Care Compare)

7640 Sylvania Ave
Suite K
Sylvania, OH 43560-9263
Phone (419) 517-1001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Sylvan Lakes Family Physicians LTD Family Medicine CurrentSince Sep 13, 2010 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Comprehensive Care Family Practice, P.C. Family Medicine Past Accepting new patients
The Orthopaedic Network, Inc. Past Accepting new patients

Locations

7640 Sylvania Ave
Ste K
Sylvania, OH 43560
Phone (419) 517-1001

Interoperability endpoints

  • Direct secure messaging: kwoodard108555@direct.bsmhealth.org

Organizations & group practices 4

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1114921095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7640 SYLVANIA AVE",
            "address_2": "SUITE K",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435609729",
            "telephone_number": "419-517-1001",
            "fax_number": "419-517-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7640 SYLVANIA AVE",
            "address_2": "SUITE K",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435609729",
            "telephone_number": "419-517-1001",
            "fax_number": "419-517-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "KRISTIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-00-5713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00038728",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2420633",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4524124",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.