Individual provider Active NPI

Katy Leigh Woodall, O.D.

  • Optometrist
  • Winchester, TN
National Provider Identifier
1376736264
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2752 Issued in TN
Practice address
183 Hospital Rd
Suite H
Winchester, TN 37398-2470
Phone
(931) 967-2230
Fax
(931) 967-9622
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2752 TN Primary

Addresses

Primary practice location

183 Hospital Rd
Suite H
Winchester, TN 37398-2470

Mailing address

183 Hospital Rd
Suite H
Winchester, TN 37398-2470
Phone (931) 967-2230

Other identifiers 1

IdentifierTypeStateIssuer
Q007544MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071217000582 TN Practitioner - Optometry 2860582640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winchester Eye Clinic, PLLCGroup PAC ID 4385993211, 2 clinicians

Practice addresses (Care Compare)

183 Hospital Rd
Suite H
Winchester, TN 37398-6207
Phone (931) 967-2230

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2752TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Eye Clinic, PLLC. Optometrist CurrentSince Apr 4, 2018 Accepting new patients

Locations

183 Hospital Rd
Ste H
Winchester, TN 37398
Phone (615) 967-2230

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1376736264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 HOSPITAL RD",
            "address_2": "SUITE H",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982470",
            "telephone_number": "931-967-2230",
            "fax_number": "931-967-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 HOSPITAL RD",
            "address_2": "SUITE H",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982470",
            "telephone_number": "931-967-2230",
            "fax_number": "931-967-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "KATY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007544",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

Verify at the official NPI Registry.