Active NPI
Amy Wood, MD
- Pediatrics Physician
- Baton Rouge, LA
National Provider Identifier
1194872069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 207694
- Practice address
- 8300 Constantin Blvd
Baton Rouge, LA 70809-3489 - Phone
- (225) 374-4325
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 207694 | LA | |
| Pediatrics Physician | 208000000X | 207694 | LA | Primary |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | P4270 | TX | |
| Hospitalist Physician | 208M00000X | P4270 | TX |
Addresses
Primary practice location
8300 Constantin Blvd
Baton Rouge, LA 70809-3489
Mailing address
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0001
Other practice location 1
3001 George Bush Hwy
Suite 250
Richardson, TX 75082-3542
Phone (214) 343-6663 ext. 227
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300802101 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://urldefense.proofpoint.com/v2/url?u=https-3A__epicproxy.et0830.epichosted.com_FHIRProxy_api_F | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207694 | LA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of the Lake Physician Group LLC | Pediatrics | Current | Accepting new patients |
| Our Lady of the Lake Physician Group LLC | Current | Accepting new patients |
Locations
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011
8300 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 374-1410
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Baton Rouge, LA
- NPI 1033494943
Pediatrics
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Baton Rouge, LA
- NPI 1235912502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608508800000",
"number": "1194872069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 S SHERWOOD FOREST BLVD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708166038",
"telephone_number": "225-526-0001",
"fax_number": "225-765-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8300 CONSTANTIN BLVD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708093489",
"telephone_number": "225-374-4325"
}
],
"practiceLocations": [
{
"address_1": "3001 George Bush Hwy",
"address_2": "Suite 250",
"address_purpose": "LOCATION",
"city": "Richardson",
"state": "TX",
"postal_code": "750823542",
"country_code": "US",
"telephone_number": "214-343-6663 x227",
"fax_number": "214-343-2814",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOOD",
"first_name": "AMY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2020-12-21",
"certification_date": "2020-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "LA",
"license": "207694",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "207694",
"primary": true
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "TX",
"license": "P4270",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "TX",
"license": "P4270",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300802101",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://urldefense.proofpoint.com/v2/url?u=https-3A__epicproxy.et0830.epichosted.com_FHIRProxy_api_F",
"affiliation": "N",
"endpointDescription": "FMOLHS FHIR URL",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "8300 Constantin Blvd",
"city": "Baton Rouge",
"state": "LA",
"country_code": "US",
"postal_code": "708093489",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.