Individual provider Active NPI

Andrea Wooddell, CNP

  • Primary Care Nurse Practitioner
  • Beachwood, OH
National Provider Identifier
1386015360
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
COA. 17889-NP Issued in OH
Practice address
3999 Richmond Rd
Beachwood, OH 44122-6046
Phone
(216) 593-5500
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X COA. 17889-NP OH Primary

Addresses

Primary practice location

3999 Richmond Rd
Beachwood, OH 44122-6046

Mailing address

3999 Richmond Rd
Beachwood, OH 44122-6046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA. 17889-NPOHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Wound Care Consultants LLC PastSince May 3, 2020 Accepting new patients

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": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1386015360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3999 RICHMOND RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441226046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 RICHMOND RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441226046",
            "telephone_number": "216-593-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODDELL",
        "first_name": "ANDREA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "COA. 17889-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.