NPIMap

Organization Active NPI

Glenn Wood MD PA

Doing business as Carousel Pediatrics

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1235356114
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GLENN WOOD MD PA
Doing business as
Carousel Pediatrics
Practice address
2410 E Riverside Dr
Ste G3
Austin, TX 78741-3083
Phone
(512) 448-4433
Fax
(512) 448-3776
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Dr. Glenn G Wood, M.D.
Title
Medical Director
Phone
(512) 448-4433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2410 E Riverside Dr
Ste G3
Austin, TX 78741-3083

Mailing address

2410 E Riverside Dr
Ste G3
Austin, TX 78741-3083
Phone (512) 448-4433

Other identifiers 2

IdentifierTypeStateIssuer
153715107MedicaidTX
153715105MedicaidTX

Other names 1

  • Carousel Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glenn Wood MD PA20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

2410 E Riverside Dr
Ste G3
Austin, TX 78741
Phone (512) 804-3000

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1235356114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 E RIVERSIDE DR",
            "address_2": "STE G3",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787413083",
            "telephone_number": "512-448-4433",
            "fax_number": "512-448-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 E RIVERSIDE DR",
            "address_2": "STE G3",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787413083",
            "telephone_number": "512-448-4433",
            "fax_number": "512-448-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN WOOD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "512-448-4433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153715107",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153715105",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carousel Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.