NPIMap

Individual provider Active NPI

David William Wood, DO

  • Family Medicine Physician
  • Poplar Bluff, MO
National Provider Identifier
1760742084
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2015008277 Issued in MO
Practice address
2360 Katy LN
Poplar Bluff, MO 63901-2300
Phone
(573) 712-2546
Fax
(573) 712-2549
NPI assigned
May 21, 2012
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SL0879 NV
Family Medicine Physician 207Q00000X 2015008277 MO Primary

Addresses

Primary practice location

2360 Katy LN
Poplar Bluff, MO 63901-2300

Mailing address

2360 Katy LN
Poplar Bluff, MO 63901-2300
Phone (573) 712-2546

Other practice location 1

1771 Commercial St
Warsaw, MO 65355-3096
Phone (660) 438-5193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150819009284 MO Practitioner - Family Practice 9931414901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poplar Bluff Hma Physician Management, LLCGroup PAC ID 5092769703, 41 clinicians

Practice addresses (Care Compare)

2360 Katy LN
Poplar Bluff, MO 63901-2300
Phone (573) 712-2546

3098 Oak Grove Rd
Poplar Bluff, MO 63901-8938
Phone (855) 444-7276

3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573
Phone (573) 776-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015008277MOMDFamily Medicine Physician
SL0879NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Memorial Hospital District Current Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Aug 1, 2015 Accepting new patients
Poplar Bluff Hma Physician Management, LLC Family Medicine CurrentSince Jan 31, 2019 Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Aug 1, 2015 Accepting new patients
Poplar Bluff Regional Medical Center LLC Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Poplar Bluff Regional Medical Center LLC Past Accepting new patients

Locations

1600 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

2360 Katy Ln
Poplar Bluff, MO 63901
Phone (573) 712-2546

3098 Oak Grove Rd
Poplar Bluff, MO 63901
Phone (573) 778-2600

Interoperability endpoints

  • Direct secure messaging: david.wood.1@8825.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1760742084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 KATY LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012300",
            "telephone_number": "573-712-2546",
            "fax_number": "573-712-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 KATY LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012300",
            "telephone_number": "573-712-2546",
            "fax_number": "573-712-2549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1771 Commercial St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "MO",
            "postal_code": "653553096",
            "country_code": "US",
            "telephone_number": "660-438-5193",
            "fax_number": "660-438-5091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "SL0879",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2015008277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.