Individual provider Active NPI

James Joseph Woda, D.C

  • Chiropractor
  • Dearborn, MI
National Provider Identifier
1609094424
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007303 Issued in MI
Practice address
23100 Cherry Hill St Ste 4
Dearborn, MI 48124-1449
Phone
(313) 724-8925
Fax
(313) 724-8926
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007303 MI Primary

Addresses

Primary practice location

23100 Cherry Hill St Ste 4
Dearborn, MI 48124-1449

Mailing address

23100 Cherry Hill St Ste 4
Dearborn, MI 48124-1449
Phone (313) 724-8925

Other identifiers 2

IdentifierTypeStateIssuer
3489405MedicaidMI
950H25371OtherMIBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120810000522 MI Practitioner - Chiropractic 0446406177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1039 Washington St
Suite 2
Dearborn, MI 48124-2016
Phone (313) 724-8925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301007303MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back Wellness Center PC Chiropractor CurrentSince Aug 6, 2012 Accepting new patients
Kelly Chiropractic, PLLC Chiropractor PastSince Aug 6, 2012 Accepting new patients

Locations

1039 Washington St
Ste 2
Dearborn, MI 48124
Phone (313) 724-8638

23100 Cherry Hill St
Ste 4
Dearborn, MI 48124
Phone (313) 724-8638

8240 N Telegraph Rd
Dearborn Hts, MI 48127
Phone (313) 724-8638

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1609094424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23100 CHERRY HILL ST STE 4",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241449",
            "telephone_number": "313-724-8925",
            "fax_number": "313-724-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 CHERRY HILL ST STE 4",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241449",
            "telephone_number": "313-724-8925",
            "fax_number": "313-724-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WODA",
        "first_name": "JAMES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3489405",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "950H25371",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.