Individual provider Active NPI

Jody Lynn Woodward, PH.D.

  • Clinical Psychologist
  • Chesterfield, MO
National Provider Identifier
1780673186
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2005005795 Issued in MO
Practice address
14561 N Outer 40 Rd
Ste 250
Chesterfield, MO 63017-5703
Phone
(636) 288-9631
Fax
(877) 842-8918
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2005005795 MO Primary

Addresses

Primary practice location

14561 N Outer 40 Rd
Ste 250
Chesterfield, MO 63017-5703

Mailing address

1976 Pickfair Dr
Saint Louis, MO 63146-3628
Phone (636) 288-9631

Other identifiers 3

IdentifierTypeStateIssuer
197560OtherMOBCBS MISSOURI
497215111MedicaidMO
797676000OtherMOMAGELLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000145 MO Practitioner - Clinical Psychologist 2567403041 Practice locations: Saint Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1976 Pickfair Dr
Saint Louis, MO 63146-3628
Phone (636) 288-9631

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas J. Lantsberger, PH.D. LLC Clinical Past Accepting new patients

Organizations & group practices 1

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780673186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1976 PICKFAIR DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463628",
            "telephone_number": "636-288-9631",
            "fax_number": "877-842-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14561 N OUTER 40 RD",
            "address_2": "STE 250",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175703",
            "telephone_number": "636-288-9631",
            "fax_number": "877-842-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2005005795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MISSOURI",
            "identifier": "197560",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497215111",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "797676000",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.