Individual provider Active NPI

Theresa Anne Woods, MD

  • Pediatrics Physician
  • Lafayette, IN
National Provider Identifier
1194784157
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01042470A Issued in IN
Practice address
2600 Ferry St
Lafayette, IN 47904-3055
Phone
(765) 448-8000
Fax
(765) 448-7611
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01042470A IN Primary

Addresses

Primary practice location

2600 Ferry St
Lafayette, IN 47904-3055

Mailing address

1200 W White River Blvd
Muncie, IN 47303-4988
Phone (877) 668-5621

Other identifiers 4

IdentifierTypeStateIssuer
100387510MedicaidIN
000000188164OtherINANTHEM PROVIDER NUMBER
9397598OtherINPHCS PID NUMBER
10826226OtherINCAQH NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address twoods1@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20081113000714 IN Practitioner - Pediatric Medicine 0042370595 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01042470AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Current Accepting new patients
Arnett Clinic, LLC CurrentSince Aug 1, 2008 Accepting new patients
Arnett Clinic, LLC Pediatrics CurrentSince Aug 1, 2008 Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

2600 Ferry St
Lafayette, IN 47904

2600 Greenbush St
Lafayette, IN 47904

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

Interoperability endpoints

  • Direct secure messaging: twoods1@direct.iuhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1194784157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 FERRY ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043055",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "THERESA",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01042470A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100387510",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000188164",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PID NUMBER",
            "identifier": "9397598",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "10826226",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twoods1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2600 Ferry St",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479043055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.