Individual provider Active NPI

Tyrone Keith Wood, MD

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1770575839
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
8903 Issued in SC
Practice address
9263 Medical Plaza Dr
Ste E
Charleston, SC 29406-7112
Phone
(843) 572-1228
Fax
(843) 576-6168
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10691 SC
Anesthesiology Physician 207L00000X 8903 SC Primary

Addresses

Primary practice location

9263 Medical Plaza Dr
Ste E
Charleston, SC 29406-7112

Mailing address

9263 Medical Plaza Dr
Ste E
Charleston, SC 29406-7112
Phone (843) 572-1228

Other identifiers 1

IdentifierTypeStateIssuer
089031MedicaidSC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10691SCMDSpecialist
8903SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesia, LLC Specialist PastSince Sep 1, 2003 Accepting new patients
Anesthesia Network Services, LLC Anesthesiology Past Accepting new patients

Organizations & group practices 2

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1770575839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR",
            "address_2": "STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228",
            "fax_number": "843-576-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR",
            "address_2": "STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228",
            "fax_number": "843-576-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "TYRONE",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "10691",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "8903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089031",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.