Individual provider Active NPI

Vance Ashley Woodward, DO

  • Family Medicine Physician
  • Kaunakakai, HI
National Provider Identifier
1275206757
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DOS-2607 Issued in HI
Practice address
280 Home Olu Place
Kaunakakai, HI 96748
Phone
(808) 553-5331
NPI assigned
Jul 29, 2021
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A20456 CA
Family Medicine Physician 207Q00000X DOS-2607 HI Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X DOS-2607 HI

Addresses

Primary practice location

280 Home Olu Place
Kaunakakai, HI 96748

Mailing address

280 Home Olu Place
Kaunakakai, HI 96748-4007
Phone (818) 409-8328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, TX2 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
I20250317003536 HI Practitioner - Family Practice 9931506953 Reassigns benefits to 1 organization
I20251003002504 TX Practitioner - Family Practice 9931506953 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12033 Agency Rd
Parker, AZ 85344-7718

PO Box
Suite 95461
Cleveland, OH 44101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012CAMDAddiction (Substance Use Disorder) Counselor
20A20456CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix CurrentSince Sep 1, 2025 Accepting new patients
Molokai General Hospital Hospice and Palliative Medicine CurrentSince Jan 13, 2025 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Sep 1, 2025 Accepting new patients
Molokai General Hospital CurrentSince Jan 13, 2025 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Sep 1, 2025 Accepting new patients
Irene Benn Medical Center CurrentSince Sep 1, 2025 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Sep 1, 2025 Accepting new patients

Locations

12033 Agency Rd
Parker, AZ 85344
Phone (760) 572-4137

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1275206757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 HOME OLU PLACE",
            "city": "KAUNAKAKAI",
            "state": "HI",
            "postal_code": "967484007",
            "telephone_number": "818-409-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 HOME OLU PLACE",
            "city": "KAUNAKAKAI",
            "state": "HI",
            "postal_code": "96748",
            "telephone_number": "808-553-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "VANCE",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-29",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A20456",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "DOS-2607",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "HI",
            "license": "DOS-2607",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaunakakai, HI

Sources for this page

Verify at the official NPI Registry.