NPIMap

Individual provider Active NPI

John William Woodward II, MD

  • Family Medicine Physician
  • Mooresville, NC
National Provider Identifier
1508072620
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036119343 Issued in IL
Practice address
111 Kilson Dr Ste 201
Mooresville, NC 28117-8218
Phone
(704) 663-2091
NPI assigned
May 15, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2013-01023 NC
Family Medicine Physician 207Q00000X 036119343 IL Primary

Addresses

Primary practice location

111 Kilson Dr Ste 201
Mooresville, NC 28117-8218

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other identifiers 5

IdentifierTypeStateIssuer
0361193431MedicaidIL
036119343MedicaidIL
0361193439MedicaidIL
36119343OtherILBCBS
P00936475OtherILRRMCARE THRU CESIISC (GES)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130830000344 NC Practitioner - Emergency Medicine 8527155746 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine and Wellness Center PAGroup PAC ID 6305983677, 2 clinicians
Piedmont Triad Physicians PLLCGroup PAC ID 6406197334, 37 clinicians

Practice addresses (Care Compare)

10320 Mallard Creek Rd
Suite 271
Charlotte, NC 28262-5204
Phone (704) 503-6321

207 Old Lexington Rd
Thomasville, NC 27360-3428
Phone (336) 472-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
82.48
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2013-01023NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Thomasville Medical Center, LLC CurrentSince Jan 19, 2024 Accepting new patients
Tanglewood Park Physicians, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Piedmont Triad Physicians, PLLC Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients
Brunswick Physician Partners, PLLC Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients
Alleghany Emergency Group LLC Emergency Medicine CurrentSince Feb 3, 2014 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince Jan 19, 2024 Accepting new patients
Kernersville Emergency Group, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Miracles Healing Centers Inc CurrentSince Sep 5, 2021 Accepting new patients
Comprehensive Emergency Solutions II SC Emergency Medicine Past Accepting new patients
Comprehensive Emergency Solutions SC Emergency Medicine Past Accepting new patients
Galesburg Professional Services LLC Emergency Medicine Past Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

111 Kilson Dr
Ste 201
Mooresville, NC 28117
Phone (704) 444-0999

233 Doctors St
Sparta, NC 28675
Phone (336) 372-3223

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: john.woodward.1@14389.direct.athenahealth.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508072620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 KILSON DR STE 201",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178218",
            "telephone_number": "704-663-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2013-01023",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036119343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361193431",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119343",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361193439",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36119343",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCARE THRU CESIISC (GES)",
            "identifier": "P00936475",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.