Individual provider Active NPI

Dawn Andrea Woodroof, MD

  • Diagnostic Radiology Physician
  • Russell Springs, KY
National Provider Identifier
1417145392
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A84696 Issued in CA
Practice address
38 Joe T Petty Drive
Russell Springs, KY 42642-8553
Phone
(606) 658-9535
Fax
(270) 266-4189
NPI assigned
Oct 4, 2007
Last updated
Aug 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A84696 CA Primary

Addresses

Primary practice location

38 Joe T Petty Drive
Russell Springs, KY 42642-8553

Mailing address

PO Box 1430
Frankfort, KY 40602-1430
Phone (502) 226-3858

Other identifiers 2

IdentifierTypeStateIssuer
43825OtherKYKENTUCKY BOARD OF MEDICAL LICENSURE
A84696OtherCACA LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922000096 KY Practitioner - Diagnostic Radiology 8527133180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Oklahoma College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

38 Dr Joe T Pettey Dr
Russell Springs, KY 42642-8533
Phone (606) 658-9535

PO Box
Suite 278
Russell Springs, KY 42642

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55 of 100Reported as individual
Quality
10
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A84696CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KBC Somerset Imaging PLLC Diagnostic Radiology CurrentSince Aug 25, 2014 Accepting new patients
Kentucky Breast Care Diagnostic Radiology CurrentSince Oct 17, 2012 Accepting new patients

Locations

38 Joe T Petty Dr
Russell Springs, KY 42642
Phone (606) 658-9535

100 Sarahs Ln
Somerset, KY 42503
Phone (606) 219-4184

40 Turpen Ct
#B
Somerset, KY 42503
Phone (606) 658-9535

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-kbc

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1417145392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406021430",
            "telephone_number": "502-226-3858",
            "fax_number": "502-227-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 JOE T PETTY DRIVE",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426428553",
            "telephone_number": "606-658-9535",
            "fax_number": "270-266-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODROOF",
        "first_name": "DAWN",
        "middle_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A84696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY BOARD OF MEDICAL LICENSURE",
            "identifier": "43825",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE NUMBER",
            "identifier": "A84696",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell Springs, KY

Sources for this page

Verify at the official NPI Registry.