Individual provider Active NPI

Latoya Tawaina Woods, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1629476668
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014036820 Issued in MO
Practice address
660 Mason Ridge Center Dr
Saint Louis, MO 63141-8509
Phone
(314) 273-6481
NPI assigned
Dec 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209022374 IL
Nurse Practitioner 363L00000X 2014036820 MO
Family Nurse Practitioner 363LF0000X 209022374 IL
Family Nurse Practitioner 363LF0000X 2014036820 MO Primary

Addresses

Primary practice location

660 Mason Ridge Center Dr
Saint Louis, MO 63141-8509

Mailing address

660 Mason Ridge Center Dr
Saint Louis, MO 63141-8509
Phone (314) 273-6481

Other practice location 1

5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone (314) 367-5820 ext. 2221

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150303001471 MO Practitioner - Nurse Practitioner 1355667700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

1225 Graham Rd
Suite 1220B
Florissant, MO 63031-8012
Phone (314) 953-8250

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

660 Mason Ridge Ctr Dr
Saint Louis, MO 63141-8509
Phone (314) 273-6481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209022374ILMDNurse Practitioner
2014036820MOMDNurse Practitioner

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": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1629476668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 MASON RIDGE CENTER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418509",
            "telephone_number": "314-273-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 MASON RIDGE CENTER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418509",
            "telephone_number": "314-273-6481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5471 Dr Martin Luther King Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631124265",
            "country_code": "US",
            "telephone_number": "314-367-5820 x2221",
            "fax_number": "314-367-7010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODS",
        "first_name": "LATOYA",
        "middle_name": "TAWAINA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022374",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2014036820",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022374",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014036820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "660 Mason Ridge Center Dr",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.