Julie Marie Woodall-Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001340 Issued in IA

Practice address

1430 North Hwy
Jackson, MN 56143-1093

Phone

(507) 847-2200

NPI assigned

Dec 6, 2005

Last updated

May 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanford Health Network

  dba Sanford Clinic Tracy

  • Family Medicine Physician
  • Tracy, MN
  • NPI 1699869875
  Medicare reassignment
• Sanford Health Network

  dba Sanford Clinic Jackson

  • Rural Health Clinic/Center
  • Jackson, MN
  • NPI 1083638357

  Physician Assistant

  NPD
• Sanford Health Network

  dba Sanford Clinic Mountain Lake

  • Rural Health Clinic/Center
  • Mountain Lake, MN
  • NPI 1568469039
  NPD
• Sanford Clinic

  dba Sanford Health Adrian Clinic

  • Family Medicine Physician
  • Adrian, MN
  • NPI 1831178052
  NPD (past)
• St Lukes Health Resources

  • Clinic/Center
  • Ponca, NE
  • NPI 1619932373
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1396729034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "507-847-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 NORTH HWY",
            "city": "JACKSON",
            "state": "MN",
            "postal_code": "561431093",
            "telephone_number": "507-847-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 N 2nd St",
            "address_purpose": "LOCATION",
            "city": "Cherokee",
            "state": "IA",
            "postal_code": "510121833",
            "country_code": "US",
            "telephone_number": "712-225-0191",
            "fax_number": "712-225-0196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODALL-SMITH",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "01410",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stacey Lynn Tweedt, LADC
• Walgreen Co
• Matthew Douglas Wasmund, CD
• Amy Lynn Winter, CFNP

• Physician Assistant in Jackson, MN
• Providers in Jackson, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.