Active NPI
David R. Woodbury, M.D.
- Family Medicine Physician
- Waterloo, IA
National Provider Identifier
1427090711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 30562
- Practice address
- 2710 Saint Francis Dr
Suite 210
Waterloo, IA 50702-5619 - Phone
- (319) 272-5000
- Fax
- (319) 272-5282
- NPI assigned
- Jun 12, 2006
- Last updated
- Jul 17, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 30562 | IA | Primary |
Addresses
Primary practice location
2710 Saint Francis Dr
Suite 210
Waterloo, IA 50702-5619
Mailing address
2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0133504 | Medicaid | IA |
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington County Hospital | Family Medicine | Past | Accepting new patients |
| Floyd County Memorial Hospital Commission | Family Medicine | Past | Accepting new patients |
| Covenant Medical Center, Inc. | Past | Accepting new patients | |
| Henry County Soldiers' and Sailors' 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1427090711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 KIMBALL AVE",
"address_2": "LL14",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025063",
"telephone_number": "319-272-1590",
"fax_number": "319-272-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 SAINT FRANCIS DR",
"address_2": "SUITE 210",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025619",
"telephone_number": "319-272-5000",
"fax_number": "319-272-5282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODBURY",
"first_name": "DAVID",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "30562",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0133504",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.