Individual provider Active NPI

Jason Daniel Woolsey, D.D.S.

  • General Practice Dentistry
  • Fort Smith, AR
National Provider Identifier
1487880324
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3705 Issued in AR
Practice address
9000 Rogers Ave
Fort Smith, AR 72903-5249
Phone
(479) 452-8193
NPI assigned
Jun 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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 3705 AR Primary

Addresses

Primary practice location

9000 Rogers Ave
Fort Smith, AR 72903-5249

Mailing address

9000 Rogers Ave
Fort Smith, AR 72903-5249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20151124001549 AR Order and Referring Only - DentistPractitioner - Dentist 6901106939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3705ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Brooks K Fiser, DDS PA PastSince Dec 13, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1487880324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035249",
            "telephone_number": "479-452-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLSEY",
        "first_name": "JASON",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.