Bolan P Woodward, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

20851 Issued in GA

Practice address

220 Northside Drive
Valdosta, GA 31602

Phone

(229) 241-2800

Fax

(229) 241-0454

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Medical College of Georgia School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern OB GYN Associates P CGroup PAC ID 8729059043, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bolanwoodward@sobgyn.allscriptsdirect.net
• Direct secure messaging: bolan.woodward@gadirect.net

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.

• Southern OB GYN Associates P C

  • Obstetrics & Gynecology Physician
  • Valdosta, GA
  • NPI 1801951454
  Medicare reassignment Care Compare group NPD
• Southern OB GYN Ambulatory Surgery Center, Inc

  • Ambulatory Surgical Clinic/Center
  • Valdosta, GA
  • NPI 1538166053
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699851337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 NORTHSIDE DRIVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-241-2800",
            "fax_number": "229-241-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 NORTHSIDE DRIVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-241-2800",
            "fax_number": "229-241-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "BOLAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "20851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffery Shane Wood, DMD
• Todd Woodard, PHARM.D.
• Shellby Lynne Woodrum, MED CCC-SLP
• Andrew D Woods, DPM
• Thomas Franklin Woods Jr., AA
• John Barclay Woodward III, DMD
• Robert Woodward, LMFT
• Shelly Woodward, OTR/L
• Ryane Mikenzie Worrell, MED CCC-SLP
• Worthington Family Dentistry, P.C.

• Obstetrics & Gynecology Physician in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.