Individual provider Active NPI

Amy Wood, MD

  • Pediatrics Physician
  • Baton Rouge, LA
National Provider Identifier
1194872069
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
207694 Issued in LA
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

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
300802101MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200916002208 LA Practitioner - Pediatric Medicine 4082753868 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207694LAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Pediatrics CurrentSince Oct 1, 2020 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Oct 1, 2020 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.

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

Verify at the official NPI Registry.