Jacob Tanner Wooldridge, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

BP10053405 Issued in TX

Practice address

4301 W Markham St
Little Rock, AR 72205-7199

Phone

(501) 686-8000

NPI assigned

May 8, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

University of Texas Medical Branch at Galveston, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Arkansas Childrens Hospital

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1598773079
  Medicare reassignment NPD
• Arkansas Childrens Professional Services Organization LLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1629889464
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1346230968
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment NPD
• Arkansas Children'S Hospital

  • Children's Hospital
  • Little Rock, AR
  • NPI 1477561983
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  • Dental Clinic/Center
  • Little Rock, AR
  • NPI 1194060830
  NPD
• University of Arkansas for Medical Sciences

  • Adolescent Medicine (Family Medicine) Physician
  • Little Rock, AR
  • NPI 1285307744
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Arkansas for Medical Sciences

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1477549756
  Care Compare affiliation

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1497133649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251420",
            "telephone_number": "501-686-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057199",
            "telephone_number": "501-686-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "775550428",
            "country_code": "US",
            "telephone_number": "409-772-2870",
            "fax_number": "409-747-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "622 West 168th Street",
            "address_2": "PH 15 West 1574",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10032",
            "country_code": "US",
            "telephone_number": "212-305-5697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOLDRIDGE",
        "first_name": "JACOB",
        "middle_name": "TANNER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-08",
        "last_updated": "2021-12-01",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E-14941",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "BP10053405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Ann Woodward, R.N.
• Gena Woodward, PT
• Jamison Woodward, LMSW
• Sondra Woodward
• Michaela Annette Woody, PT, DPT
• Amanda Gayle Woolems, LMSW
• Katrin Wooley, APRN
• Sherry Wooley, R.N.
• Kristyl J Woolsey, APRN
• Meredith Woosley, DPT

• Anatomic Pathology & Clinical Pathology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Anatomic Pathology & Clinical Pathology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.

Verify at the official NPI Registry.