Individual provider Active NPI

Bridgette E Woodcock, LPN

  • Licensed Practical Nurse
  • Jacksonville, NC
National Provider Identifier
1750059200
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
88433 Issued in NC
Practice address
215C Station St
Jacksonville, NC 28546-6304
Phone
(910) 577-2972
Fax
(910) 577-8359
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 88433 NC Primary

Addresses

Primary practice location

215C Station St
Jacksonville, NC 28546-6304

Mailing address

125 Colonial Post Rd
Jacksonville, NC 28546-0114
Phone (910) 787-2013

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
88433NCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1750059200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COLONIAL POST RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285460114",
            "telephone_number": "910-787-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215C STATION ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466304",
            "telephone_number": "910-577-2972",
            "fax_number": "910-577-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODCOCK",
        "first_name": "BRIDGETTE",
        "middle_name": "E",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "88433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.