Individual provider Active NPI

Jeffrey Scott Woodruff, DC

  • Chiropractor
  • Manheim, PA
National Provider Identifier
1629164546
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011484 Issued in PA
Practice address
1223 Lancaster Rd
Manheim, PA 17545-9803
Phone
(717) 879-9910
Fax
(717) 879-9912
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011484 PA Primary
Chiropractor 111N00000X 1993 AL

Addresses

Primary practice location

1223 Lancaster Rd
Manheim, PA 17545-9803

Mailing address

1223 Lancaster Rd
Manheim, PA 17545-9803
Phone (717) 879-9910

Other identifiers 3

IdentifierTypeStateIssuer
200123662OtherALALL OTHER INSURANCE
51517785OtherALBCBS
825083672OtherPAALL OTHER INSURANCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120418000372 AL Practitioner - Chiropractic 3779744719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

960 Schillinger Rd S
Suite D
Mobile, AL 36695-8975
Phone (251) 525-9512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC011484PAMDChiropractor
1993ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Petrey Chiropractic, LLC Chiropractor CurrentSince May 1, 2020 Accepting new patients
Body Mind & Spine Chiropractor CurrentSince Nov 14, 2022 Accepting new patients

Locations

960 Schillinger Rd S
Ste D
Mobile, AL 36695
Phone (251) 525-9512

1516 Schillinger Rd S
Mobile, AL 36695
Phone (251) 635-1224

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1629164546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 LANCASTER RD",
            "city": "MANHEIM",
            "state": "PA",
            "postal_code": "175459803",
            "telephone_number": "717-879-9910",
            "fax_number": "717-879-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 LANCASTER RD",
            "city": "MANHEIM",
            "state": "PA",
            "postal_code": "175459803",
            "telephone_number": "717-879-9910",
            "fax_number": "717-879-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011484",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1993",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL OTHER INSURANCE",
            "identifier": "200123662",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51517785",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL OTHER INSURANCE",
            "identifier": "825083672",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manheim, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.