Individual provider Active NPI

John R Wooley, MD

  • Obstetrics & Gynecology Physician
  • Jackson, MS
National Provider Identifier
1174577944
Registry record updated Nov 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
10041 Issued in MS
Practice address
501 Marshall Street
Suite 400
Jackson, MS 39202-1687
Phone
(601) 354-0869
Fax
(601) 352-6521
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 10041 MS Primary
Maternal & Fetal Medicine Physician 207VM0101X 10041 MS

Addresses

Primary practice location

501 Marshall Street
Suite 400
Jackson, MS 39202-1687

Mailing address

501 Marshall Street
Suite 400
Jackson, MS 39202-1867
Phone (601) 354-0869

Other identifiers 1

IdentifierTypeStateIssuer
0015896MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110113000794 MS Practitioner - Obstetrics/Gynecology 9335338862

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Mississippi School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Womans Clinic of Ms PLLCGroup PAC ID 7214003441, 11 clinicians

Practice addresses (Care Compare)

501 Marshall St
Suite 400
Jackson, MS 39202-1687
Phone 60135408694011

Hospital & facility affiliations

  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Merit-based Incentive Payment System (MIPS)

Final score
23.28 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
77.59

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10041MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caroline a Reich MD PC PastSince Jan 11, 2020 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1174577944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MARSHALL STREET",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021867",
            "telephone_number": "601-354-0869",
            "fax_number": "601-352-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL STREET",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021687",
            "telephone_number": "601-354-0869",
            "fax_number": "601-352-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLEY",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "10041",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MS",
            "license": "10041",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015896",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.