Carol A Wood

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

309-003503 Issued in IL

Practice address

151 N Main St
Decatur, IL 62523-1206

Phone

(217) 362-6262

NPI assigned

Jul 19, 2007

Last updated

Sep 13, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1316147317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625250710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231206",
            "telephone_number": "217-362-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "CAROL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "IL",
            "license": "309-003503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Witts
• Wolf and Osborne, LTD
• Kevin Thomas Wolf, DMD
• Matthew Paul Wolter, CRNA
• Women's Health Care Specialists of Decatur, LLC
• Elizabeth R Wood
• Sheila J Woodrow, DC
• Garyn Julia Woodruff
• Terence R Woods, M.D.
• Elizabeth Christine Woodworth

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Decatur, IL
• Providers in Decatur, IL by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.