NPIMap

Individual provider Active NPI

David L Woodruff, M.D.

  • Family Medicine Physician
  • Pandora, OH
National Provider Identifier
1154317188
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-05-7705-W Issued in OH
Practice address
202 Hilty Dr
Pandora, OH 45877-9478
Phone
(419) 384-3251
Fax
(419) 384-3269
NPI assigned
Sep 26, 2005
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 35-05-7705-W OH Primary

Addresses

Primary practice location

202 Hilty Dr
Pandora, OH 45877-9478

Mailing address

202 Hilty Drive
PO Box 299
Pandora, OH 45877-0299
Phone (419) 384-3251

Other identifiers 1

IdentifierTypeStateIssuer
0791004MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100105000506 OH Practitioner - Family Practice 1658358874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pandora Family Physicians, Inc.Group PAC ID 8123001963, 5 clinicians

Practice addresses (Care Compare)

202 Hilty Dr
Pandora, OH 45877-9478
Phone (419) 384-3251

PO Box
Suite 299
Pandora, OH 45877-0299

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pandora Family Physicians, Inc. Family Medicine CurrentSince Jul 1, 1990 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mennonite Memorial Home Past Accepting new patients
Blanchard Valley Regional Health Center PastSince Apr 30, 2003 Accepting new patients
Mennonite Memorial Home Past Accepting new patients
Mennonite Memorial Home Past Accepting new patients

Locations

161 Garau St
Bluffton, OH 45817
Phone (419) 358-0925

202 Hilty Dr
Pandora, OH 45877
Phone (419) 384-3251

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mennonite Memorial HomeBluffton, OH, CCN 366144 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 31, 2024
Dec 31, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1154317188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 HILTY DRIVE",
            "address_2": "PO BOX 299",
            "city": "PANDORA",
            "state": "OH",
            "postal_code": "458770299",
            "telephone_number": "419-384-3251",
            "fax_number": "419-384-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HILTY DR",
            "city": "PANDORA",
            "state": "OH",
            "postal_code": "458779478",
            "telephone_number": "419-384-3251",
            "fax_number": "419-384-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-05-7705-W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0791004",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pandora, OH

Sources for this page

Verify at the official NPI Registry.