NPIMap

Organization Active NPI

Dr. Roderic L. Woodson II M.D.

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1376917062
Registry record updated Nov 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7789 Issued in GA
Legal business name
DR. RODERIC L. WOODSON II M.D.
Practice address
105 Collier Rd NW Ste 1000
Atlanta, GA 30309-1730
Phone
(404) 352-8522
NPI assigned
Nov 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2015

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

Authorized official

Name
Roderic L. Woodson, M.D.NPI 1558547943
Title
Physician
Phone
(404) 352-8522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 7789 GA Primary

Addresses

Primary practice location

105 Collier Rd NW Ste 1000
Atlanta, GA 30309-1730

Mailing address

105 Collier Rd NW Ste 1000
Atlanta, GA 30309-1730
Phone (404) 352-8522

Other names 1

  • Georgia Renal Specialist Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Georgia Renal Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448755200000",
    "number": "1376917062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COLLIER RD NW STE 1000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091730",
            "telephone_number": "404-352-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COLLIER RD NW STE 1000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091730",
            "telephone_number": "404-352-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RODERIC L. WOODSON II M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-29",
        "status": "A",
        "authorized_official_last_name": "WOODSON",
        "authorized_official_first_name": "RODERIC",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "404-352-8522",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Renal Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.