Individual provider Active NPI

Michael Woodard, FNP-C

  • Family Nurse Practitioner
  • Chester, GA
National Provider Identifier
1659866549
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN177985 Issued in GA
Practice address
2971 Old Bethel Rd
Chester, GA 31012-2659
Phone
(478) 358-7219
NPI assigned
Jun 25, 2018
Last updated
Aug 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN177985 GA Primary

Addresses

Primary practice location

2971 Old Bethel Rd
Chester, GA 31012-2659

Mailing address

2971 Old Bethel Rd
Chester, GA 31012-2659
Phone (478) 358-7219

Other practice location 1

1412 Plunket Rd
Unadilla, GA 31091-5600
Phone (478) 627-2000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN177985GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1659866549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 OLD BETHEL RD",
            "city": "CHESTER",
            "state": "GA",
            "postal_code": "310122659",
            "telephone_number": "478-358-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2971 OLD BETHEL RD",
            "city": "CHESTER",
            "state": "GA",
            "postal_code": "310122659",
            "telephone_number": "478-358-7219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1412 Plunket Rd",
            "address_purpose": "LOCATION",
            "city": "Unadilla",
            "state": "GA",
            "postal_code": "310915600",
            "country_code": "US",
            "telephone_number": "478-627-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "MICHAEL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN177985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.