Active NPI
Grace Shirley Woods, PA-C
- Physician Assistant
- San Diego, CA
National Provider Identifier
1629555032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 4910 Directors PL Ste 350
San Diego, CA 92121-3834 - Phone
- (858) 571-9550
- NPI assigned
- Jul 27, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA55813 | CA | |
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
4910 Directors PL Ste 350
San Diego, CA 92121-3834
Mailing address
4910 Directors PL Ste 350
San Diego, CA 92121-3834
Other practice location 1
2725 Capitol Ave Dept 302
Sacramento, CA 95816-6006
Phone (916) 262-9440
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1151742 | Other | CA | NON-MEDICARE |
| 1151742 | Other | CA | CERTIFICATION BY THE NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55813 | CA | MD | Dentist |
| PA55813 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699142400000",
"number": "1629555032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4910 DIRECTORS PL STE 350",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4910 DIRECTORS PL STE 350",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213834",
"telephone_number": "858-571-9550"
}
],
"practiceLocations": [
{
"address_1": "2725 Capitol Ave Dept 302",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958166006",
"country_code": "US",
"telephone_number": "916-262-9440",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOODS",
"first_name": "GRACE",
"middle_name": "SHIRLEY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-27",
"last_updated": "2023-11-05",
"certification_date": "2023-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA55813",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NON-MEDICARE",
"identifier": "1151742",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFICATION BY THE NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANT",
"identifier": "1151742",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.