Individual provider Active NPI

Tabitha R Woodard, APN

  • Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1265962120
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
22894 Issued in TN
Practice address
2863 Highway 45 Byp
Jackson, TN 38305-3618
Phone
(731) 422-0213
Fax
(731) 660-8369
NPI assigned
Jun 14, 2017
Last updated
Jul 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 22894 TN Primary

Addresses

Primary practice location

2863 Highway 45 Byp
Jackson, TN 38305-3618

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 425-5752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171122000944 TN Practitioner - Nurse Practitioner 1355608605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Physician Network, LLCGroup PAC ID 2365701943, 74 clinicians

Practice addresses (Care Compare)

8507 US Hwy 51 N
Suite 107
Millington, TN 38053-1535
Phone (901) 873-2555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Physician Network, LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

2018 S Germantown Rd
Memphis, TN 38138
Phone (901) 754-8880

6005 Park Ave
Ste 601
Memphis, TN 38119
Phone (901) 680-9205

8507 US Highway 51 N
Ste 107
Millington, TN 38053
Phone (901) 873-2555

Interoperability endpoints

  • Direct secure messaging: tabitha.woodard.2@16700.direct.athenahealth.com

Organizations & group practices 1

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 1

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1265962120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-425-5752",
            "fax_number": "731-422-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 HIGHWAY 45 BYP",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053618",
            "telephone_number": "731-422-0213",
            "fax_number": "731-660-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "TABITHA",
        "middle_name": "R",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "22894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.