Individual provider Active NPI

Edward Woo, MD

  • Obstetrics & Gynecology Physician
  • Bolivia, NC
National Provider Identifier
1760412043
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2011-01658 Issued in NC
Practice address
584 Hospital Dr
Suite B
Bolivia, NC 28422
Phone
(910) 721-4050
Fax
(910) 721-4051
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2011-01658 NC Primary

Addresses

Primary practice location

584 Hospital Dr
Suite B
Bolivia, NC 28422

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

Other identifiers 3

IdentifierTypeStateIssuer
5918904MedicaidNC
887938900MedicaidMN
2011-01658OtherNCNORTH CAROLINA MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20111222000127 NC Practitioner - Obstetrics/Gynecology 8123010402 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Feb 8, 2019 Accepting new patients
Obhg North Carolina, P.C. Obstetrics & Gynecology CurrentSince Aug 31, 2016 Accepting new patients
Vidant Medical Group LLC CurrentSince Feb 8, 2019 Accepting new patients

Locations

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1760412043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 HOSPITAL DR",
            "address_2": "SUITE B",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "28422",
            "telephone_number": "910-721-4050",
            "fax_number": "910-721-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOO",
        "first_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2011-01658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918904",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887938900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA MEDICAL BOARD",
            "identifier": "2011-01658",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.