Active NPI
Mark Douglas Wofford, MD
- Diagnostic Radiology Physician
- Baton Rouge, LA
National Provider Identifier
1467432286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 12503R
- Practice address
- 8230 Summa Ave Ste C
Baton Rouge, LA 70809-3465 - Phone
- (225) 757-0552
- Fax
- (225) 763-9997
- NPI assigned
- Jan 18, 2006
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 12503R | LA | Primary |
Addresses
Primary practice location
8230 Summa Ave Ste C
Baton Rouge, LA 70809-3465
Mailing address
8230 Summa Ave Ste C
Baton Rouge, LA 70809-3465
Phone (225) 757-0552
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5H747 | Other | LA | MEDICARE |
| 1493481 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Arkansas College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 757-0552
Hospital & facility affiliations
- Our Lady of the Lake Regional Medical Center
- Our Lady of Lourdes Regional Medical Center, Inc
- Christus St Frances Cabrini Hospital
- Christus Shreveport-Bossier Health System
- Christus Ochsner St Patrick Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12503R | LA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology Associates LLC | Diagnostic Radiology | Current | Accepting new patients |
| Administrators of the Tulane Educational Fund | Past | Accepting new patients |
Locations
8230 Summa Ave
Ste C
Baton Rouge, LA 70809
7135 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 765-7875
5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050
1104 W Highway 30
Gonzales, LA 70737
Phone (225) 215-1321
1100 N 18th St
Ste 100
Monroe, LA 71201
Phone (318) 361-9900
900 Johnson St
Tallulah, LA 71282
Phone (318) 395-2241
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 and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Baton Rouge, LA
- NPI 1659347771
-
- Specialist
- New Orleans, LA
- NPI 1528014164
Hospital & facility affiliations 26
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Student Health Clinic/Center
- Pineville, LA
- NPI 1023139458
Hospital
-
- Student Health Clinic/Center
- Pineville, LA
- NPI 1093836421
Hospital
-
- Student Health Clinic/Center
- Provencal, LA
- NPI 1164687307
Hospital
-
- Student Health Clinic/Center
- Natchitoches, LA
- NPI 1356462782
Hospital
-
- Student Health Clinic/Center
- Marthaville, LA
- NPI 1609031962
Hospital
-
- General Acute Care Hospital
- Alexandria, LA
- NPI 1639160799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420934400000",
"number": "1467432286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8230 SUMMA AVE STE C",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708093465",
"telephone_number": "225-757-0552",
"fax_number": "225-763-9997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8230 SUMMA AVE STE C",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708093465",
"telephone_number": "225-757-0552",
"fax_number": "225-763-9997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOFFORD",
"first_name": "MARK",
"middle_name": "DOUGLAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2015-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "LA",
"license": "12503R",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "5H747",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1493481",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.