Active NPI
Jamie M Woodson, PA-C
- Physician Assistant
- San Antonio, TX
National Provider Identifier
1336379718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA13308
- Practice address
- 7400 Merton Minter St
San Antonio, TX 78229-4404 - Phone
- (210) 617-5300
- Fax
- (210) 949-3625
- NPI assigned
- Jul 21, 2009
- Last updated
- Sep 25, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA13308 | TX | Primary |
| Medical Physician Assistant | 363AM0700X | NU | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
7400 Merton Minter St
San Antonio, TX 78229-4404
Mailing address
7400 Merton Minter St
San Antonio, TX 78229-4404
Other practice location 1
7410 John Smith Dr Ste 212
San Antonio, TX 78229-6000
Phone (210) 697-9500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191025001399 | TX | Order and Referring Only - Physician Assistant | 3577895465 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA13308 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1336379718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 MERTON MINTER ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 MERTON MINTER ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294404",
"telephone_number": "210-617-5300",
"fax_number": "210-949-3625"
}
],
"practiceLocations": [
{
"address_1": "7410 John Smith Dr Ste 212",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782296000",
"country_code": "US",
"telephone_number": "210-697-9500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOODSON",
"first_name": "JAMIE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-21",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA13308",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.