Active NPI
Courtney Stoltz Woollen, DMD
- General Practice Dentistry
- Morgantown, WV
National Provider Identifier
1629536156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9252
- Practice address
- 1 Medical Center Dr
Morgantown, WV 26506-1200 - Phone
- (304) 293-6208
- NPI assigned
- Mar 4, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9252 | SC | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Morgantown, WV 26506-1200
Mailing address
Wvu School of Dentistry
1 Medical Center Drive
Morgantown, WV 26506
Phone (304) 293-6208
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 5, 2021 through Apr 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9252 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663286400000",
"number": "1629536156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WVU SCHOOL OF DENTISTRY",
"address_2": "1 MEDICAL CENTER DRIVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "26506",
"telephone_number": "304-293-6208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265061200",
"telephone_number": "304-293-6208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLLEN",
"first_name": "COURTNEY",
"middle_name": "STOLTZ",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-04",
"last_updated": "2022-09-16",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "9252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.