Individual provider Active NPI

Deborah Ann Davidson Woods, PNP

  • Pediatric Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1174799464
Registry record updated Oct 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
X331266 Issued in CA
Practice address
2279 45TH St Ste 1246
Sacramento, CA 95817-1514
Phone
(916) 734-4899
Fax
(916) 456-4501
NPI assigned
May 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 139550 MO
Pediatric Nurse Practitioner 363LP0200X X331266 CA Primary

Addresses

Primary practice location

2279 45TH St Ste 1246
Sacramento, CA 95817-1514

Mailing address

2279 45TH St Ste 1246
Sacramento, CA 95817-1514
Phone (916) 734-4899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171208002678 CA Practitioner - Nurse Practitioner 4486780715 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
X331266CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Oct 24, 2017 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Oct 24, 2017 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

643 W East Ave
Chico, CA 95926
Phone (530) 342-0502

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4501 X St
Sacramento, CA 95817
Phone (916) 734-5959

2279 45th St
Ste 1246
Sacramento, CA 95817
Phone (916) 734-4899

4501 X St
Fl 2
Sacramento, CA 95817
Phone (916) 734-5959

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

Organizations & group practices 4

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": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509062400000",
    "number": "1174799464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 45TH ST STE 1246",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171514",
            "telephone_number": "916-734-4899",
            "fax_number": "916-456-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 45TH ST STE 1246",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171514",
            "telephone_number": "916-734-4899",
            "fax_number": "916-456-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON WOODS",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2017-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "139550",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "X331266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.