Jill D Woodham, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1049498 Issued in AL

Practice address

1118 Ross Clark Cir
Suite 100
Dothan, AL 36301-3001

Phone

(334) 794-1148

Fax

(334) 793-1954

NPI assigned

Jun 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laura Jill Dansby Woodham Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.37

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.

• Dothan Medical Associates, P.C.

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1972693778
  Medicare reassignment NPD

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1659576494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 100",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-794-1148",
            "fax_number": "334-793-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 100",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-794-1148",
            "fax_number": "334-793-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODHAM",
        "first_name": "JILL",
        "middle_name": "D",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1049498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "DANSBY WOODHAM",
            "middle_name": "JILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy Marvin Woodall, CRNA
• James Woodcox, LICSW, ADC
• Chanetta Lashan Woodham, CRNP
• Cynthia Lynn Woodham, FNP
• David Bruce Woodham, MD
• Regan Woodham, AGACNP-BC
• Laura Wool, LPC
• Natalie E Wozniak, CRNA
• Vanessa Christian Wren, PHYSICAL THERAPY
• Clayton L Wright, DMD

• Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.

Verify at the official NPI Registry.