Individual provider Active NPI

Joshua Woodin, P.A.-C

  • Physician Assistant
  • Yulee, FL
National Provider Identifier
1407921323
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3715 Issued in FL
Practice address
463832 Sr 200
Yulee, FL 32097-3638
Phone
(904) 225-2311
Fax
(904) 225-8481
NPI assigned
Nov 24, 2006
Last updated
Nov 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002962 GA
Physician Assistant 363A00000X PA3715 FL Primary
Physician Assistant 363A00000X 101281 NC
Physician Assistant 363A00000X 003429 NY

Addresses

Primary practice location

463832 Sr 200
Yulee, FL 32097-3638

Mailing address

PO Box 44004
Jacksonville, FL 32231-4004
Phone (904) 376-3707

Other identifiers 1

IdentifierTypeStateIssuer
P01431327OtherFLRAILROAD MEDICARE

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2962GAMDMental Health Counselor
101281NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Past Accepting new patients
Mayo Clinic Health System in Waycross, Inc. Past Accepting new patients
Baptist Primary Care Inc Physician Assistant Past Accepting new patients
Early Memorial Hospital Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1407921323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44004",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314004",
            "telephone_number": "904-376-3707",
            "fax_number": "904-225-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463832 SR 200",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320973638",
            "telephone_number": "904-225-2311",
            "fax_number": "904-225-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODIN",
        "first_name": "JOSHUA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002962",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3715",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101281",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003429",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01431327",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yulee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.