Individual provider Active NPI

Lorie C Woods, OD

  • Optometrist
  • Enterprise, AL
National Provider Identifier
1174510614
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S623TA097 Issued in AL
Practice address
812 E Lee St
Enterprise, AL 36330-2011
Phone
(334) 393-2020
Fax
(334) 393-6936
NPI assigned
Sep 30, 2005
Last updated
Sep 11, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S623TA097 AL Primary

Addresses

Primary practice location

812 E Lee St
Enterprise, AL 36330-2011

Mailing address

812 E Lee St
Enterprise, AL 36330-2011
Phone (334) 393-2020

Other identifiers 3

IdentifierTypeStateIssuer
51004506OtherALBLUE CROSS BLUE SHIELD
111905OtherEYEMED
5878510001OtherALCIGNA GOV'T SERVICES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070216000616 AL Practitioner - Optometry 3971605221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S623TA097ALMDOptometrist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1174510614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E LEE ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302011",
            "telephone_number": "334-393-2020",
            "fax_number": "334-393-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E LEE ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302011",
            "telephone_number": "334-393-2020",
            "fax_number": "334-393-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "LORIE",
        "middle_name": "C",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S623TA097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51004506",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "111905",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOV'T SERVICES",
            "identifier": "5878510001",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.