NPIMap

Individual provider Active NPI

Edith Woody, MD

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1639100308
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
028673 Issued in GA
Practice address
3106 Mercer University Dr
Macon, GA 31204-5109
Phone
(478) 314-0890
Fax
(478) 314-0894
NPI assigned
Jul 5, 2006
Last updated
Feb 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 28673 GA
Family Medicine Physician 207Q00000X 028673 GA Primary

Addresses

Primary practice location

3106 Mercer University Dr
Macon, GA 31204-5109

Mailing address

3106 Mercer University Dr
Macon, GA 31204-5109
Phone (478) 314-0890

Other identifiers 2

IdentifierTypeStateIssuer
564758011AMedicaidGA
008829OtherGABLUE CROSS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28673GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adel Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Dodge Emergency Group LLC Emergency Medicine Past Accepting new patients
Taylor Regional Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Dodge County Hospital Authority Family Medicine PastSince Sep 4, 2022 Accepting new patients
McRae Emergency Physcians LLC Emergency Medicine Past Accepting new patients
Complete Care & Pain Management Institute,LLC Past Accepting new patients
McRae Emergency Services, LLC Emergency Medicine Past Accepting new patients
Sterling Emergency Services of the Southeast Inc Emergency Medicine Past Accepting new patients

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1639100308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 MERCER UNIVERSITY DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312045109",
            "telephone_number": "478-314-0890",
            "fax_number": "478-314-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 MERCER UNIVERSITY DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312045109",
            "telephone_number": "478-314-0890",
            "fax_number": "478-314-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODY",
        "first_name": "EDITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "28673",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "028673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "564758011A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "008829",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.