Jason Wodley, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1780379172 Issued in IN

Practice address

3200 Cold Spring Rd Apt 105
Indianapolis, IN 46222-1960

Phone

(818) 300-6509

NPI assigned

Apr 10, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: jwodley566062@direct.parkviewexchange.com

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1780379172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 COLD SPRING RD APT 105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221960",
            "telephone_number": "818-300-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 COLD SPRING RD APT 105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221960",
            "telephone_number": "818-300-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WODLEY",
        "first_name": "JASON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "1780379172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alysan Wittmer
• Joy Renee Witto, PHARMD
• Matthew Scott Wittrig, D.D.S.
• Angela Rena Witzmann, CNS/APRN
• John M Wo, MD
• Nathan Joseph Woebkenberg, PA-C
• Alyxandra Gertrude Woenker
• Stephanie E Woerner, NP
• Emily Marie Wogtech, DPT
• Kimberly Nicole Wohlberg, FNP-C

• Internal Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.