NPIMap

Organization Active NPI

Thomas C. Wooldridge a Professional Corporation

  • Surgery Physician
  • Bastrop, LA
National Provider Identifier
1770794604
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
13859 Issued in LA
Legal business name
THOMAS C. WOOLDRIDGE A PROFESSIONAL CORPORATION
Practice address
1921 North Washington St.
Bastrop, LA 71221-1640
Phone
(318) 283-0400
Fax
(318) 283-0400
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Authorized official

Name
Dr. Thomas Clayton Wooldridge, M.D.
Title
Chairman
Phone
(318) 283-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 13859 LA Primary

Addresses

Primary practice location

1921 North Washington St.
Bastrop, LA 71221-1640

Mailing address

1921 North Washington St.
P. O. Box 1640
Bastrop, LA 71221-1640
Phone (318) 283-0400

Other identifiers 1

IdentifierTypeStateIssuer
1303712MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Thomas C Wooldirdge MD a Professional Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1770794604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 NORTH WASHINGTON ST.",
            "address_2": "P. O. BOX 1640",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712211640",
            "telephone_number": "318-283-0400",
            "fax_number": "318-283-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 NORTH WASHINGTON ST.",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712211640",
            "telephone_number": "318-283-0400",
            "fax_number": "318-283-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS C. WOOLDRIDGE A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "WOOLDRIDGE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "CLAYTON",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "318-283-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "LA",
            "license": "13859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303712",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.