NPIMap

Individual provider Active NPI

Angela Michelle Woodford, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1639953565
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4016629 Issued in KY
Practice address
3015 Wilson Ave
Louisville, KY 40211-1969
Phone
(502) 774-4401
NPI assigned
Aug 22, 2023
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 1099305 KY
Nurse Practitioner 363L00000X 4016629 KY
Family Nurse Practitioner 363LF0000X 4016629 KY Primary

Addresses

Primary practice location

3015 Wilson Ave
Louisville, KY 40211-1969

Mailing address

3015 Wilson Ave
Louisville, KY 40211-1969
Phone (502) 774-4401

Other practice location 1

3039 Breckenridge Ln
Louisville, KY 40220-2101
Phone (502) 451-4555

Other identifiers 1

IdentifierTypeStateIssuer
7100973180MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513003446 KY Practitioner - Nurse Practitioner 0143550772 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3015 Wilson Ave
Louisville, KY 40211-1969
Phone 50277444011509

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1099305KYMDCritical Care Medicine Registered Nurse
4016629KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince May 6, 2024 Accepting new patients
Park Duvalle Community Health Center, Inc. CurrentSince Jan 13, 2025 Accepting new patients
Park Duvalle Community Health Center, Inc. Current Accepting new patients
Park Duvalle Community Health Center, Inc CurrentSince Jan 13, 2025 Accepting new patients

Locations

3015 Wilson Ave
Louisville, KY 40211
Phone (502) 774-4401

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

9080 Taylorsville Rd
Louisville, KY 40299
Phone (502) 491-8805

501 Taylorsville Rd
Taylorsville, KY 40071
Phone (502) 477-2248

Interoperability endpoints

  • Direct secure messaging: angela.woodford.1@27238.direct.athenahealth.com
  • Direct secure messaging: angela.woodford@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1639953565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 WILSON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111969",
            "telephone_number": "502-774-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 WILSON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111969",
            "telephone_number": "502-774-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3039 Breckenridge Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402202101",
            "country_code": "US",
            "telephone_number": "502-451-4555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODFORD",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "KY",
            "license": "1099305",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4016629",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4016629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100973180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.