Randly Lysander Woods, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME102215 Issued in FL

Practice address

7487 S State Road 121
Macclenny, FL 32063-5451

Phone

(904) 259-6211

Fax

(904) 259-7104

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1689680662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7487 S STATE ROAD 121",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320635451",
            "telephone_number": "904-259-6211",
            "fax_number": "904-259-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7487 S STATE ROAD 121",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320635451",
            "telephone_number": "904-259-6211",
            "fax_number": "904-259-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "RANDLY",
        "middle_name": "LYSANDER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "08-00277",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME102215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia F White, DO
• Annie Clara Widemond, C.PH.T.
• Lonna Elaine Wilkes, PHARM.D.
• Willow Tree Therapy Services LLC
• Jill Woodall
• Blayne O Yerby, PA
• Jeremie Joseph Young, MD
• Edward Bernard Zebooker, D.O.

• Psychiatry Physician in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.