Individual provider Active NPI

Brian R Woody, MD

  • Family Medicine Physician
  • Viroqua, WI
National Provider Identifier
1174527832
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35939 Issued in WI
Practice address
407 S Main St
Viroqua, WI 54665-4000
Phone
(608) 637-4750
Fax
(608) 637-3120
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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 35939 WI Primary

Addresses

Primary practice location

407 S Main St
Viroqua, WI 54665-4000

Mailing address

407 S Main St
Ste 400
Viroqua, WI 54665-4000
Phone (608) 637-4750

Other identifiers 1

IdentifierTypeStateIssuer
32061400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20051026000428 WI Practitioner - Family Practice 6709803083 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vernon Memorial Healthcare IncGroup PAC ID 8325958416, shared by 6 NPIs, 73 clinicians

Practice addresses (Care Compare)

206 N Mill St
La Farge, WI 54639-6601
Phone (608) 625-2494

Hospital & facility affiliations

  • Commonheart Home Health Home health agency, Waukesha, WI, CCN 527151
  • Aveanna Home Health Home health agency, La Crosse, WI, CCN 527336
  • St Croix Hospice la Crosse Hospice, La Crosse, WI, CCN 521507
  • St Croix Hospice Baraboo Hospice, Baraboo, WI, CCN 521591
  • Commonheart Hospice Hospice, Waukesha, WI, CCN 521578
  • Vernon Memorial Hospital Hospital, Viroqua, WI, CCN 521348
  • Vernon Manor Nursing home, Viroqua, WI, CCN 525562
  • Soldiers Grove Health Services Nursing home, Soldiers Grove, WI, CCN 525622

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35939WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vernon Memorial Healthcare, Inc. CurrentSince Nov 1, 2005 Accepting new patients
Vernon Memorial Healthcare, Inc. CurrentSince Nov 1, 2005 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jun 1, 2017 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jun 1, 2017 Accepting new patients
Vernon Memorial Healthcare, Inc Current Accepting new patients

Locations

206 N Mill St
La Farge, WI 54639
Phone (608) 625-2494

7102 Mineral Point Rd
Madison, WI 53717
Phone (608) 828-7603

2402 Winnebago St
Madison, WI 53704
Phone (608) 242-6840

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

102 Sunset Ave
Soldiers Grove, WI 54655
Phone (608) 624-5203

407 S Main St
Ste 400
Viroqua, WI 54665
Phone (608) 637-3174

507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101

407 S Main St
Viroqua, WI 54665
Phone (608) 637-3195

100 Melby St
Westby, WI 54667
Phone (608) 634-3125

Interoperability endpoints

  • Direct secure messaging: bwoody1971@direct.emplifyhealth.org

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Vernon ManorViroqua, WI, CCN 525562 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Dec 2, 2024
Dec 2, 2024
Soldiers Grove Health ServicesSoldiers Grove, WI, CCN 525622 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jul 22, 2024
Jul 22, 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 5

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 8

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1174527832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S MAIN ST",
            "address_2": "STE 400",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546654000",
            "telephone_number": "608-637-4750",
            "fax_number": "608-637-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S MAIN ST",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546654000",
            "telephone_number": "608-637-4750",
            "fax_number": "608-637-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODY",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "35939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32061400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Viroqua, WI

Sources for this page

Verify at the official NPI Registry.