Matthew Shaun Woodruff, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Post Office Box 66038
Marine Aircraft Group 31
Beaufort, SC 29904-6038

Phone

(843) 228-6257

NPI assigned

Sep 17, 2015

Sex

Male

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)

Not enrolled

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1346619558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITE POND BLVD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299023338",
            "telephone_number": "210-551-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 66038",
            "address_2": "MARINE AIRCRAFT GROUP 31",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299046038",
            "telephone_number": "843-228-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "MATTHEW",
        "middle_name": "SHAUN",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominika Sara Wisniewska, DMD
• Richard Herman Woerndle, DO
• Karen Konomi Wolf, DMD
• Suzanne Wolf, FNP RN MSN
• Audrey M Woodley-Cruz, FNP-BC
• Katherine Elizabeth Workman, PTA
• Wright Choice Diagnosis Center
• Angela Wright, LPCA
• Erika Lynne Wright, RN-BSN
• Keetra Wright, RBT

• Independent Duty Corpsman in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Independent Duty Corpsman in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.