Active NPI
John B Woodbury, DO
- Emergency Medicine Physician
- Manteca, CA
National Provider Identifier
1275562878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 20A5306
- Practice address
- 1205 E North St
Manteca, CA 95336-4932 - Phone
- (209) 239-8301
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 20A5306 | CA | Primary |
| Family Medicine Physician | 207Q00000X | 20A5306 | CA |
Addresses
Primary practice location
1205 E North St
Manteca, CA 95336-4932
Mailing address
3916 State St
#300
Santa Barbara, CA 93105-5602
Phone (805) 563-3011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX53060 | Medicaid | CA |
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 Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakdale Medical Group Inc | Emergency Medicine | Past | Accepting new patients |
| JW Medical Care | Family Medicine | Past | Accepting new patients |
| California Em-I Medical Services, a Medical Corporation | Emergency Medicine | Past | Accepting new patients |
| UCSF Health Community Hospitals | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Lake Isabella, CA
- NPI 1053360156
-
- Family Medicine Physician
- Danville, CA
- NPI 1881092799
-
- Emergency Medicine Physician
- Oakdale, CA
- NPI 1598862054
-
- General Acute Care Hospital
- San Francisco, CA
- NPI 1316061997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245801600000",
"number": "1275562878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3916 STATE ST",
"address_2": "#300",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931055602",
"telephone_number": "805-563-3011",
"fax_number": "805-564-5087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 E NORTH ST",
"city": "MANTECA",
"state": "CA",
"postal_code": "953364932",
"telephone_number": "209-239-8301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODBURY",
"first_name": "JOHN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2009-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "20A5306",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A5306",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX53060",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manteca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.