NPIMap

Individual provider Active NPI

Samuel T Woods, MD

  • Internal Medicine Physician
  • High Point, NC
National Provider Identifier
1558340042
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101-048623 Issued in VA
Practice address
624 Quaker LN
Suite 200 D
High Point, NC 27262-3832
Phone
(336) 802-2075
Fax
(336) 802-2076
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101-048623 VA Primary

Addresses

Primary practice location

624 Quaker LN
Suite 200 D
High Point, NC 27262-3832

Mailing address

607 Idol St
High Point, NC 27262-7804
Phone (336) 802-2000

Other identifiers 2

IdentifierTypeStateIssuer
5855420MedicaidVA
8989146MedicaidNC

Other names 1

  • Dr. Samuel Wodnicki Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101-048623VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation Past Accepting new patients
Wake Forest Health Network, LLC Past Accepting new patients
Cornerstone Health Care PA Past Accepting new patients
Carilion Healthcare Corporation Past Accepting new patients
Cogent Healthcare of North Carolina, PC Internal Medicine Past Accepting new patients

Organizations & group practices 5

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1558340042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 IDOL ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627804",
            "telephone_number": "336-802-2000",
            "fax_number": "336-802-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 QUAKER LN",
            "address_2": "SUITE 200 D",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623832",
            "telephone_number": "336-802-2075",
            "fax_number": "336-802-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "SAMUEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101-048623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5855420",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8989146",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "WODNICKI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.