Samuel Bryan Wood

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0997339-NP Issued in CO

Practice address

Corner of Route N12 and N7
Fort Defiance, AZ 86504

Phone

(928) 729-8600

NPI assigned

Nov 29, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, CO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

93.85 of 100Reported as group

Quality

91.15

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Usacs of Colorado, Inc

  • Emergency Medicine Physician
  • Littleton, CO
  • NPI 1760415871
  Medicare reassignment NPD
• The Fort Defiance Indian Hospital Board, Incorporation

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Frisco, CO
  • NPI 1255967345
  NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Lakewood, CO
  • NPI 1720614217
  NPD

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1154835197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Belleview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141838",
            "country_code": "US",
            "telephone_number": "540-981-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "SAMUEL",
        "middle_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-29",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "VA",
            "license": "00000000000",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "000000000000",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "VA",
            "license": "000000000000",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0997339-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Purvis Winters, DMD
• Alison Wissinger
• Hailemariam Mekite Wolde, D.O.
• Karen Hoiwan Wong-Li, RD, LD
• Jennie Wong, PHARM D
• Lakitta Monchelle Woods-Dwelle, O.D.
• Teresa Wrenn, PHARMD
• Angelena Yazzie
• Cecelia Yazzie, EDD
• Chastity Rhae Yazzie

• Family Nurse Practitioner in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.