NPIMap

Individual provider Active NPI

Adam Woolley

  • Physician Assistant
  • Columbia, TN
National Provider Identifier
1770172975
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4832 Issued in TN
Practice address
1224 Trotwood Ave
Columbia, TN 38401-4802
Phone
(931) 381-1111
NPI assigned
Jan 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4832 TN Primary

Addresses

Primary practice location

1224 Trotwood Ave
Columbia, TN 38401-4802

Mailing address

3715 Trousdale LN
Columbia, TN 38401-8965
Phone (951) 776-6040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220228000174 TN Practitioner - Physician Assistant 9032525811 Reassigns benefits to 10 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4832TNMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: awoolley23033@mlh.direct-ci.com

Organizations & group practices 10

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": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1770172975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 TROUSDALE LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384018965",
            "telephone_number": "951-776-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 TROTWOOD AVE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014802",
            "telephone_number": "931-381-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLLEY",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.