Active NPI
John Robert Woods, M.D.
- Emergency Medicine Physician
- South Bend, IN
National Provider Identifier
1316046485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 01031817A
- Practice address
- 615 N Michigan St
South Bend, IN 46601-1033 - Phone
- (574) 647-7459
- Fax
- (574) 647-3411
- NPI assigned
- Sep 22, 2006
- Last updated
- Feb 15, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 01031817A | IN | Primary |
Addresses
Primary practice location
615 N Michigan St
South Bend, IN 46601-1033
Mailing address
328 N Michigan St
Suite 200
South Bend, IN 46601-1244
Phone (574) 647-1842
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000636043 | Other | IN | ANTHEM PROVIDER NUMBER |
| 100385150 | Medicaid | IN |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01031817A | IN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Health System, Inc. | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266192000000",
"number": "1316046485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "328 N MICHIGAN ST",
"address_2": "SUITE 200",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011244",
"telephone_number": "574-647-1842",
"fax_number": "574-647-1825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 N MICHIGAN ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011033",
"telephone_number": "574-647-7459",
"fax_number": "574-647-3411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "JOHN",
"middle_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2010-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01031817A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "000000636043",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100385150",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.