Active NPI
Gary Lee Wood, PSYD
- Clinical Psychologist
- Tampa, FL
National Provider Identifier
1518912997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY0002699
- Practice address
- 4700 N. Habana Ave.
Suite 300
Tampa, FL 33614-7160 - Phone
- (813) 870-0392
- Fax
- (813) 871-6305
- NPI assigned
- May 23, 2006
- Last updated
- Jul 15, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY0002699 | FL | Primary |
Addresses
Primary practice location
4700 N. Habana Ave.
Suite 300
Tampa, FL 33614-7160
Mailing address
4700 N. Habana Ave.
Suite 300
Tampa, FL 33614-7160
Phone (813) 870-0392
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74390 | Other | FL | BCBS |
| 39977 | Other | FL | BCBS GRP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247616000000",
"number": "1518912997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 N. HABANA AVE.",
"address_2": "SUITE 300",
"city": "TAMPA",
"state": "FL",
"postal_code": "336147160",
"telephone_number": "813-870-0392",
"fax_number": "813-871-6305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 N. HABANA AVE.",
"address_2": "SUITE 300",
"city": "TAMPA",
"state": "FL",
"postal_code": "336147160",
"telephone_number": "813-870-0392",
"fax_number": "813-871-6305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "GARY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-23",
"last_updated": "2009-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY0002699",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "74390",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GRP",
"identifier": "39977",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.