Active NPI
William Shane Woodall, PA-C
- Medical Physician Assistant
- Fort Lauderdale, FL
National Provider Identifier
1619209889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 9104825
- Practice address
- 305 S Andrews Ave
601
Ft Lauderdale, FL 33301-1859 - Phone
- (954) 767-0273
- NPI assigned
- Feb 12, 2010
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 9104825 | FL | Primary |
Addresses
Primary practice location
305 S Andrews Ave
601
Ft Lauderdale, FL 33301-1859
Mailing address
35 Venetian Way
94
Miami Beach, FL 33139-8806
Phone (305) 989-1135
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9104825 | FL | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1619209889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 VENETIAN WAY",
"address_2": "94",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331398806",
"telephone_number": "305-989-1135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 S ANDREWS AVE",
"address_2": "601",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333011859",
"telephone_number": "954-767-0273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODALL",
"first_name": "WILLIAM",
"middle_name": "SHANE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-12",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "9104825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.