Individual provider Active NPI

John B Wood, MD

  • Orthopaedic Surgery Physician
  • Herrin, IL
National Provider Identifier
1154425882
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Practice address
510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948
Phone
(618) 997-6800
Fax
(618) 998-9124
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X IL Primary

Addresses

Primary practice location

510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948

Mailing address

510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948
Phone (618) 997-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20100722000723 IL Practitioner - Orthopedic Surgery 2062497704 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036091061ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Orthopedic Associates SC Orthopaedic Surgery CurrentSince Oct 16, 2000 Accepting new patients
Southern Illinois Medical Services, NFP PastSince Jun 30, 2017 Accepting new patients

Locations

305 W Jackson St
Ste 400
Carbondale, IL 62901
Phone (618) 351-4972

510 Lincoln Dr
Herrin, IL 62948
Phone (618) 997-3100

Interoperability endpoints

  • Direct secure messaging: jwood143@yourcarecommunity.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154425882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DRIVE",
            "address_2": "SOUTHERN ORTHOPEDIC ASSOCIATES SC",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DRIVE",
            "address_2": "SOUTHERN ORTHOPEDIC ASSOCIATES SC",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.