Individual provider Active NPI

Jennifer M Woodward, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Chicago, IL
National Provider Identifier
1245490812
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
036137819 Issued in IL
Practice address
675 N Saint Clair St Ste 18-200
Chicago, IL 60611-5929
Phone
(312) 695-4525
Fax
(312) 695-6007
NPI assigned
Jun 16, 2008
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2010-00328 NC
Geriatric Medicine (Family Medicine) Physician 207QG0300X 2010-00328 NC
Geriatric Medicine (Family Medicine) Physician 207QG0300X 036137819 IL Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2010-00328 NC

Addresses

Primary practice location

675 N Saint Clair St Ste 18-200
Chicago, IL 60611-5929

Mailing address

675 N Saint Clair St Ste 18-200
Chicago, IL 60611-5929
Phone (312) 695-4525

Other practice location 1

2709 Water Ridge Pkwy
Ste 500
Charlotte, NC 28217-4596
Phone (704) 446-9173

Other practice location 2

2001 Vail Ave
Ste 400
Charlotte, NC 28207-1248
Phone (704) 304-7000

Other practice location 3

101 E W T Harris Blvd
Charlotte, NC 28262-3485
Phone (704) 863-9850

Other practice location 4

1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone (704) 446-9987

Other practice location 5

1106 Reynolds St
Ste 100
Monroe, NC 28112-4375
Phone (704) 289-5443

Other practice location 6

675 N Saint Clair St Ste 18-200
Chicago, IL 60611-5929
Phone (312) 695-4525

Other names 1

  • Jennifer Fernandez Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jwoodward136857@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110714000092 NC Practitioner - Geriatric Medicine 4183892300 Reassigns benefits to 3 organizations
I20240710002871 IL Practitioner - Geriatric Medicine 4183892300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Medical University of South Carolina College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

675 N St Clair
200 Dept of Internal Med
Chicago, IL 60611-5975
Phone (312) 695-8630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036137819ILMDGeriatric Medicine (Family Medicine) Physician
2010-00328NCMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Jan 25, 2021 Accepting new patients
Carolinas Medical Center Family Medicine CurrentSince Jan 25, 2021 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 2, 2024 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Jul 31, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 2, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center CurrentSince Jan 25, 2021 Accepting new patients
Central Dupage Physician Group Family Medicine Past Accepting new patients
TST Medical, P.a. Family Medicine Past Accepting new patients
Sterling Emergency Services of the Southeast, Inc Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Ste 18-200
Chicago, IL 60611
Phone (312) 695-4525

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

101 E Wt Harris Blvd
Charlotte, NC 28262
Phone (704) 863-0640

101 E Wt Harris Blvd
Ste 1110
Charlotte, NC 28262
Phone (704) 339-1073

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1801 Rozzelles Ferry Rd
Charlotte, NC 28208
Phone (704) 446-9987

2001 Vail Ave
Ste 400
Charlotte, NC 28207
Phone (704) 304-7000

2709 Water Ridge Pkwy
Ste 500
Charlotte, NC 28217
Phone (704) 446-9173

4525 Cameron Valley Pkwy
Ste 3100
Charlotte, NC 28211
Phone (704) 302-8375

1106 Reynolds St
Ste 100
Monroe, NC 28112
Phone (704) 289-5443

Interoperability endpoints

  • Direct secure messaging: jwoodward136857@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1245490812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115929",
            "telephone_number": "312-695-4525",
            "fax_number": "312-695-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115929",
            "telephone_number": "312-695-4525",
            "fax_number": "312-695-6007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2709 Water Ridge Pkwy",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282174596",
            "country_code": "US",
            "telephone_number": "704-446-9173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Vail Ave",
            "address_2": "Ste 400",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071248",
            "country_code": "US",
            "telephone_number": "704-304-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E W T Harris Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-9850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 Rozzelles Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282084228",
            "country_code": "US",
            "telephone_number": "704-446-9987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1106 Reynolds St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281124375",
            "country_code": "US",
            "telephone_number": "704-289-5443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 N Saint Clair St Ste 18-200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115929",
            "country_code": "US",
            "telephone_number": "312-695-4525",
            "fax_number": "312-695-6007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2010-00328",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "2010-00328",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036137819",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "2010-00328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwoodward136857@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "101 E W T Harris Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282623485",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FERNANDEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.