Active NPI
Susan Bernadette Woods, O.D.
- Optometrist
- Melbourne, FL
National Provider Identifier
1780719732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC 2573
- Practice address
- 1371 Bedford Dr
Melbourne, FL 32940-1975 - Phone
- (321) 301-4651
- Fax
- (321) 383-7361
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC 2573 | FL | Primary |
Addresses
Primary practice location
1371 Bedford Dr
Melbourne, FL 32940-1975
Mailing address
1371 Bedford Dr
Melbourne, FL 32940-1975
Phone (321) 301-4651
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AG499 | Other | FL | PTAN |
| 5886500001 | Other | FL | MEDICARE DME |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC 2573 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488326400000",
"number": "1780719732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1371 BEDFORD DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329401975",
"telephone_number": "321-301-4651",
"fax_number": "321-383-7361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1371 BEDFORD DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329401975",
"telephone_number": "321-301-4651",
"fax_number": "321-383-7361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "SUSAN",
"middle_name": "BERNADETTE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2017-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC 2573",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "AG499",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE DME",
"identifier": "5886500001",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.