Individual provider Active NPI

William A Wood Jr., MD

  • Diagnostic Radiology Physician
  • Newport News, VA
National Provider Identifier
1235243114
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101034357 Issued in VA
Practice address
860 Omni Blvd
Suite 102
Newport News, VA 23606-4430
Phone
(757) 873-1935
Fax
(757) 223-7760
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101034357 VA Primary

Addresses

Primary practice location

860 Omni Blvd
Suite 102
Newport News, VA 23606-4430

Mailing address

860 Omni Blvd
Suite 303
Newport News, VA 23606-4430
Phone (757) 232-8769

Other identifiers 2

IdentifierTypeStateIssuer
P00093212OtherVARR MEDICARE
010058970MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101034357VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC Diagnostic Radiology CurrentSince Apr 1, 2006 Accepting new patients
Tidewater Physicians Multispecialty Group PC Past Accepting new patients
Peninsula Radiological Associates Limited Diagnostic Radiology PastSince Aug 28, 2021 Accepting new patients

Locations

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

827 Diligence Dr
Ste 100
Newport News, VA 23606

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

860 Omni Blvd
Ste 102
Newport News, VA 23606
Phone (757) 534-7975

860 Omni Blvd
Ste 105
Newport News, VA 23606
Phone (757) 873-0952

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1235243114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "SUITE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "SUITE 102",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-873-1935",
            "fax_number": "757-223-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101034357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00093212",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010058970",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.