NPIMap

Individual provider Active NPI

Kirk Woodward, M.D.

  • Family Medicine Physician
  • Vernal, UT
National Provider Identifier
1811083348
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
117005-1205 Issued in UT
Practice address
379 North 500 West
Suite 1a
Vernal, UT 84078
Phone
(435) 789-1165
Fax
(435) 789-1169
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 117005-1205 UT Primary

Addresses

Primary practice location

379 North 500 West
Suite 1a
Vernal, UT 84078

Mailing address

379 North 500 West
Suite 1a
Vernal, UT 84078
Phone (435) 789-1165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100618000215 UT Practitioner - Family Practice 8820071053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Utah Medical GroupGroup PAC ID 2961496609, 52 clinicians

Practice addresses (Care Compare)

379 N 500
Vernal, UT 84078-1956
Phone (435) 781-2030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.32 of 100Reported as apm
Quality
71.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Utah Medical Group Family Medicine CurrentSince Oct 8, 2019 Accepting new patients
Northeastern Utah Medical Group CurrentSince Oct 8, 2019 Accepting new patients

Locations

50 E 200 S
Duchesne, UT 84021
Phone (435) 738-2426

210 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

405 N 500 W
Vernal, UT 84078
Phone (435) 781-2335

475 N 500 W
Vernal, UT 84078
Phone (435) 781-2030

379 N 500 W
#1A
Vernal, UT 84078

379 N 500 W
Ste 1A
Vernal, UT 84078
Phone (435) 789-1165

379 N 500 W
Vernal, UT 84078
Phone (435) 781-2030

Interoperability endpoints

  • Direct secure messaging: kirk.woodward.1@13794.direct.athenahealth.com
  • Direct secure messaging: jya8646@yourcarecommunity.org
  • Direct secure messaging: kirk.woodward.1@17226.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Uintah Care CenterVernal, UT, CCN 465092 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF
Indirect Ownership Interest		 Feb 1, 2006
May 8, 2025
Feb 1, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1811083348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 NORTH 500 WEST",
            "address_2": "SUITE 1A",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "84078",
            "telephone_number": "435-789-1165",
            "fax_number": "435-789-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 NORTH 500 WEST",
            "address_2": "SUITE 1A",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "84078",
            "telephone_number": "435-789-1165",
            "fax_number": "435-789-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "KIRK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "117005-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernal, UT

Sources for this page

Verify at the official NPI Registry.