Individual provider Active NPI

Clifton Mac Gregor Woodford, M.D.

  • Family Medicine Physician
  • Sheboygan, WI
National Provider Identifier
1528041787
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55998-20 Issued in WI
Practice address
2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Phone
(920) 457-4461
Fax
(920) 459-1483
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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 55998-20 WI Primary

Addresses

Primary practice location

2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129

Mailing address

2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Phone (920) 457-4461

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170918003659 FL Practitioner - Family PracticePractitioner - Emergency Medicine 5496916421 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55998-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Global Physician Network LLC Series II CurrentSince Dec 1, 2017 Accepting new patients
Decatur County General Hospital Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients

Locations

1040 River Heritage Blvd
Bradenton, FL 34212
Phone (941) 917-6440

6331 S Tamiami Trl
Sarasota, FL 34231
Phone (941) 917-5678

6331 S Tamiami Trl
#1
Sarasota, FL 34231
Phone (941) 917-5678

Interoperability endpoints

  • Direct secure messaging: cwoodford45335@aurora.direct-ci.com

Organizations & group practices 4

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1528041787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 KOHLER MEMORIAL DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813129",
            "telephone_number": "920-457-4461",
            "fax_number": "920-459-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 KOHLER MEMORIAL DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813129",
            "telephone_number": "920-457-4461",
            "fax_number": "920-459-1483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODFORD",
        "first_name": "CLIFTON",
        "middle_name": "MAC GREGOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "55998-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.