Individual provider Active NPI

Michael D Woody, D.D.S.

  • General Practice Dentistry
  • Carthage, MO
National Provider Identifier
1467533380
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
013682 Issued in MO
Practice address
2832 Hazel St
Carthage, MO 64836-7894
Phone
(417) 358-2233
Fax
(417) 358-2355
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 013682 MO Primary

Addresses

Primary practice location

2832 Hazel St
Carthage, MO 64836-7894

Mailing address

2832 Hazel St
Carthage, MO 64836-7894
Phone (417) 358-2233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150612000056 MO Order and Referring Only - DentistPractitioner - Dentist 9032420328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467533380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2832 HAZEL ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648367894",
            "telephone_number": "417-358-2233",
            "fax_number": "417-358-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2832 HAZEL ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648367894",
            "telephone_number": "417-358-2233",
            "fax_number": "417-358-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODY",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MO

Sources for this page

Verify at the official NPI Registry.