Individual provider Active NPI

Raymond Frederick Woods, APRN

  • Family Nurse Practitioner
  • Madison, IN
National Provider Identifier
1194425884
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3017752 Issued in KY
Practice address
1373 N Sr 62
Madison, IN 47250-7328
Phone
(812) 801-0800
NPI assigned
Mar 9, 2023
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3017752 KY Primary

Addresses

Primary practice location

1373 N Sr 62
Madison, IN 47250-7328

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 559-9378

Other identifiers 3

IdentifierTypeStateIssuer
300090765MedicaidIN
K0010685OtherKYMEDICARE
7100977090MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240621001237 KY Practitioner - Nurse Practitioner 1557804366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
BLDG Suite303
Louisville, KY 40202-1831
Phone (502) 629-5552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3017752KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Family Current Accepting new patients
Community Medical Associates, Inc. Family CurrentSince Aug 1, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2024 Accepting new patients

Locations

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

200 E Chestnut St
Ste 303
Louisville, KY 40202
Phone (502) 629-5552

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Organizations & group practices 3

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": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1194425884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-559-9378",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 N SR 62",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472507328",
            "telephone_number": "812-801-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "RAYMOND",
        "middle_name": "FREDERICK",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-09",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300090765",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K0010685",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100977090",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, IN

Sources for this page

Verify at the official NPI Registry.