Individual provider Active NPI

Michael D Woolman, MD

  • Family Medicine Physician
  • Ogden, UT
National Provider Identifier
1508833450
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
163657-1205 Issued in UT
Practice address
5740 Crestwood Dr
Ogden, UT 84405-4869
Phone
(801) 479-7771
Fax
(801) 475-7795
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 163657-1205 UT Primary

Addresses

Primary practice location

5740 Crestwood Dr
Ogden, UT 84405-4869

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 479-7771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20100810000179 UT Practitioner - Family Practice 3870627060 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
163657-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic Specialty Services LLC Current Accepting new patients
Ogden Clinic PC Family Medicine CurrentSince Dec 1, 2016 Accepting new patients

Locations

5495 S 500 E
Ste 350
Ogden, UT 84405
Phone (801) 475-3100

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

5740 Crestwood Dr
South Ogden, UT 84405
Phone (801) 479-7771

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 2

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1508833450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-479-7771",
            "fax_number": "801-479-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 CRESTWOOD DR",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054869",
            "telephone_number": "801-479-7771",
            "fax_number": "801-475-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLMAN",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "163657-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.