NPIMap

Organization Active NPI

Glenn Wood MD PA

Doing business as Carousel Pediatrics

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1659598068
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GLENN WOOD MD PA
Doing business as
Carousel Pediatrics
Practice address
7112 Ed Bluestein Blvd
Suite 100
Austin, TX 78723-2900
Phone
(512) 744-6000
Fax
(512) 744-6010
NPI assigned
Apr 19, 2007
Last updated
Jul 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Authorized official

Name
Dr. Glenn Wood, M.D.NPI 1346247749
Title
Medical Director
Phone
(512) 744-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Pediatric OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WP0200X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

7112 Ed Bluestein Blvd
Suite 100
Austin, TX 78723-2900

Mailing address

7112 Ed Bluestein Blvd
Suite 100
Austin, TX 78723-2900
Phone (512) 744-6000

Other identifiers 2

IdentifierTypeStateIssuer
153715101MedicaidTX
153715102MedicaidTX

Other names 1

  • Carousel Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carousel Pediatrics20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1659598068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7112 ED BLUESTEIN BLVD",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232900",
            "telephone_number": "512-744-6000",
            "fax_number": "512-744-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7112 ED BLUESTEIN BLVD",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232900",
            "telephone_number": "512-744-6000",
            "fax_number": "512-744-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN WOOD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "512-744-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153715101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153715102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carousel Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.