NPIMap

Organization Active NPI

Charles D Woods, MD PC

  • Specialist
  • Decatur, AL
National Provider Identifier
1396938213
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
23250 Issued in AL
Legal business name
CHARLES D WOODS, MD PC
Practice address
1320 14TH Ave SE
Decatur, AL 35601-4348
Phone
(256) 355-3645
Fax
(256) 355-0610
NPI assigned
Aug 23, 2007
Last updated
Oct 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Authorized official

Name
Charles D Woods, MDNPI 1396748786
Title
Physician/Owner
Phone
(256) 355-3645

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
Specialist 174400000X 23250 AL Primary

Addresses

Primary practice location

1320 14TH Ave SE
Decatur, AL 35601-4348

Mailing address

1320 14TH Ave SE
Decatur, AL 35601-4348
Phone (256) 355-3645

Other identifiers 2

IdentifierTypeStateIssuer
529920690MedicaidAL
009965315MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804001932 AL Part B Supplier - Clinic/Group Practice 7315918091 Receives reassigned benefits from 2 practitioners
Practice locations: Decatur, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381190400000",
    "number": "1396938213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 14TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014348",
            "telephone_number": "256-355-3645",
            "fax_number": "256-355-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 14TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014348",
            "telephone_number": "256-355-3645",
            "fax_number": "256-355-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES D WOODS, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2013-10-08",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "256-355-3645",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "23250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529920690",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009965315",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.