Susan McCullough Wood, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

457 Issued in ND

Practice address

100 4TH St S
Fargo, ND 58103-1929

Phone

(701) 234-3100

NPI assigned

Jan 24, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

Merit-based Incentive Payment System (MIPS)

Final score

82.73 of 100Reported as group

Quality

71.75

Promoting interoperability

100

Improvement activities

40

Cost

70.68

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swood1841220@direct.sanfordhealth.org

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.

• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924
  Medicare reassignment Care Compare group NPD
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD

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

• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  Hospital

  Care Compare affiliation
• Sanford Medical Center Fargo

  dba Sanford Physical Therapy

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1245519081
  Care Compare affiliation
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  Care Compare affiliation
• Sanford Medical Center Fargo

  • Air Ambulance
  • Fargo, ND
  • NPI 1942415468

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  dba Sanford Bemidji

  • Ambulatory Surgical Clinic/Center
  • Bemidji, MN
  • NPI 1093876922

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1669777561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 1ST AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031802",
            "telephone_number": "701-234-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031929",
            "telephone_number": "701-234-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 1st Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581031802",
            "country_code": "US",
            "telephone_number": "701-234-4021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "SUSAN",
        "middle_name": "MCCULLOUGH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "ND",
            "license": "457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swood1841220@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "700 1st Ave S",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581031802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swood1841220@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "100 4th St S",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581031929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph Arthur Wonderlich, PH.D.
• Stephen A Wonderlich, PHD
• Earl Wood, LAPC
• Kathleen Ann Wood, MD
• Kelsey F Wood, APRN,CRNA
• Victoria Woodard, LPN
• Kara Bliss Woodbury Fladland, LPCC
• Megan Jean Woodbury, RN, CWON
• Shaylie Woodford
• Erica Woodruff

• Clinical Neuropsychologist in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Neuropsychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.