Shirene Woodham, DNP FNP-BC AGACNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

226355 Issued in AZ

Practice address

4135 S Power Rd Ste 129
Mesa, AZ 85212-3627

Phone

(480) 751-3091

Fax

(480) 751-3095

NPI assigned

Aug 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Prescott Healthcare Solutions LLC

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1821454505
  Medicare reassignment Care Compare group NPD
• Pentz Health Services LLC

  • Sports Physician Chiropractor
  • Mesa, AZ
  • NPI 1184762890
  Medicare reassignment NPD
• Desert Life Primary Care LLC

  • Nurse Practitioner
  • Mesa, AZ
  • NPI 1649943655
  NPD
• Infinite Health & Wellness Centers PLLC

  • Chiropractor
  • Mesa, AZ
  • NPI 1114206638

  Acute Care

  NPD (past)
• Sundance Medical Associates PLLC

  • Family Medicine Physician
  • Gilbert, AZ
  • NPI 1942481718
  NPD (past)

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1326527508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123627",
            "telephone_number": "480-751-3091",
            "fax_number": "480-751-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123627",
            "telephone_number": "480-751-3091",
            "fax_number": "480-751-3095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3035 S ELLSWORTH RD",
            "address_2": "STE 121",
            "address_purpose": "LOCATION",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122137",
            "country_code": "US",
            "telephone_number": "480-280-7229",
            "fax_number": "480-280-0719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODHAM",
        "first_name": "SHIRENE",
        "name_prefix": "Dr.",
        "credential": "DNP FNP-BC AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "226355",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "226355",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "226355",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "226355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Elliot Wood
• Tiffany Kaye Wood, FNP-C
• Chasity Woodard
• Tamara Lynne Woodard, LCSW
• Suzanne Marie Woodhall, RN, AGACNP-BC
• Christine Woodhouse, FNP-BC
• Kayana Makeda Woodley
• Ramona Beatrice Woodriffe, MD
• Anthony Joseph Woodruff, M.D.
• Bradley Woodruff

• Family Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.