Dr. Shelley Woody, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA1875 Issued in MD

Legal business name

DR. SHELLEY WOODY, LLC

Practice address

575 E Ordnance Rd
Glen Burnie, MD 21060-6555

Phone

(410) 590-8625

Fax

(410) 590-8648

NPI assigned

May 12, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Shelley Dorae Woody, O.D.

Title

President/Owner

Phone

(410) 590-8625

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1497047179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 E ORDNANCE RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210606555",
            "telephone_number": "410-590-8625",
            "fax_number": "410-590-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E ORDNANCE RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210606555",
            "telephone_number": "410-590-8625",
            "fax_number": "410-590-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SHELLEY WOODY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "WOODY",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "DORAE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "410-590-8625",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Glen Burnie, MD
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• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.