Active NPI
Samuel Woodle, MD
- Neurological Surgery Physician
- Portsmouth, VA
National Provider Identifier
1417410515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 73759-20
- Practice address
- 620 John Paul Jones Cir
Portsmouth, VA 23708-2111 - Phone
- (757) 953-5000
- NPI assigned
- Apr 8, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 73759-20 | WI | Primary |
| General Practice Physician | 208D00000X | 73759-20 | WI |
Addresses
Primary practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Mailing address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-5000
Other practice location 1
8901 Wisconsin Avenue
Walter Reed Neurosurgery Residency
Bethesda, MD 20889
Phone (301) 295-4420
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73759-20 | WI | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780963200000",
"number": "1417410515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-5000"
}
],
"practiceLocations": [
{
"address_1": "8901 Wisconsin Avenue",
"address_2": "Walter Reed Neurosurgery Residency",
"address_purpose": "LOCATION",
"city": "Bethesda",
"state": "MD",
"postal_code": "20889",
"country_code": "US",
"telephone_number": "301-295-4420",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOODLE",
"first_name": "SAMUEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-08",
"last_updated": "2026-06-09",
"certification_date": "2026-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "WI",
"license": "73759-20",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WI",
"license": "73759-20",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.