NPIMap

Organization Active NPI

Deirdre Wood MD PC

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1740383348
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DEIRDRE WOOD MD PC
Practice address
8001 Roosevelt Boulevard
Smylie Times BLDG; Suite 307
Philadelphia, PA 19152-3039
Phone
(267) 731-1333
Fax
(267) 731-1284
NPI assigned
Sep 7, 2006
Last updated
Feb 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Authorized official

Name
Deirdre Wood, MD
Title
Owner
Phone
(267) 731-1333

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA
Dermatology Physician 207N00000X PA Primary

Addresses

Primary practice location

8001 Roosevelt Boulevard
Smylie Times BLDG; Suite 307
Philadelphia, PA 19152-3039

Mailing address

8001 Roosevelt Boulevard
Smylie Times BLDG; Suite 307
Philadelphia, PA 19152-3039
Phone (267) 731-1333

Other identifiers 1

IdentifierTypeStateIssuer
7018518OtherPAAETNA

National Provider Directory

National Provider Directory

Locations

7901 Bustleton Ave
Ste 305
Philadelphia, PA 19152
Phone (215) 307-6112

8001 Roosevelt Blvd
Ste 307
Philadelphia, PA 19152
Phone (267) 440-0090

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1740383348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 ROOSEVELT BOULEVARD",
            "address_2": "SMYLIE TIMES BLDG; SUITE 307",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523039",
            "telephone_number": "267-731-1333",
            "fax_number": "267-731-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 ROOSEVELT BOULEVARD",
            "address_2": "SMYLIE TIMES BLDG; SUITE 307",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523039",
            "telephone_number": "267-731-1333",
            "fax_number": "267-731-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEIRDRE WOOD MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-731-1333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7018518",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.