Brent L Woodbury, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E2222 Issued in CA

Practice address

6700 N First St
Suite 105
Fresno, CA 93710

Phone

(559) 431-0757

Fax

(559) 431-0758

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Illinois Medical College, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821154881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 N FIRST ST",
            "address_2": "SUITE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-431-0757",
            "fax_number": "559-431-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N FIRST ST",
            "address_2": "SUITE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-431-0757",
            "fax_number": "559-431-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURY",
        "first_name": "BRENT",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E22220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rande Phillips Wood, M.A.
• Robbyn Wood
• Sammantha J Wood
• Jonathan Woodard, LMFT #123611
• Brandon Woodbury, M.D.
• Laura Ann Woodend
• Matthew Brunson Woodle, MD
• John Tyler Woodley, DO
• Jolana R. Woodruff, PA-C
• Alexis Mozelle Lolita Woods, PHARMD

• Podiatrist in Fresno, CA
• Providers in Fresno, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.