Individual provider Active NPI

Mary Virginia Woods, CPNP

  • Pediatric Nurse Practitioner
  • Jenkintown, PA
National Provider Identifier
1396028262
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP017207 Issued in PA
Practice address
261 Old York Rd Ste 620
Jenkintown, PA 19046-3719
Phone
(215) 885-8700
Fax
(215) 885-8795
NPI assigned
Sep 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP017207 PA Primary

Addresses

Primary practice location

261 Old York Rd Ste 620
Jenkintown, PA 19046-3719

Mailing address

261 Old York Rd Ste 620
Jenkintown, PA 19046-3719
Phone (215) 885-8700

Other names 1

  • Mia Woods Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031000596 PA Practitioner - Nurse Practitioner 0345516720 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP017207PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Care Group, P.C. CurrentSince Aug 26, 2017 Accepting new patients
Hatboro Pediatrics, PC CurrentSince Jun 21, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

261 Old York Rd
Ste 620
Jenkintown, PA 19046
Phone (215) 855-8700

483 E County Line Rd
Warminster, PA 18974
Phone (215) 441-5670

Organizations & group practices 3

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": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1396028262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 OLD YORK RD STE 620",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463719",
            "telephone_number": "215-885-8700",
            "fax_number": "215-885-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 OLD YORK RD STE 620",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463719",
            "telephone_number": "215-885-8700",
            "fax_number": "215-885-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "MARY",
        "middle_name": "VIRGINIA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP017207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "WOODS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jenkintown, PA

Sources for this page

Verify at the official NPI Registry.