Kristin Woodbury, D.O.

Primary specialty

Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X

License

20A 11724 Issued in CA

Practice address

1710 Pennsylvania Ave
Ste D
Fairfield, CA 94533-3549

Phone

(707) 432-2000

Fax

(707) 432-2001

NPI assigned

May 3, 2007

Sex

Female

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 CA

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

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.

• Northbay Healthcare Group

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD (past)
• Solano Regional Medical Group, Inc.

  • Family Medicine Physician
  • Fairfield, CA
  • NPI 1528085578

  Otolaryngology

  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1861614067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 PENNSYLVANIA AVE",
            "address_2": "SUITE D",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333589",
            "telephone_number": "707-432-2000",
            "fax_number": "707-432-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 PENNSYLVANIA AVE",
            "address_2": "STE D",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333549",
            "telephone_number": "707-432-2000",
            "fax_number": "707-432-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURY",
        "first_name": "KRISTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "OS015105",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "CA",
            "license": "20A 11724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Joanna Wolf, DO
• Victoria Wong-Chiu, PHARMD
• Godfrey E Wong, MD
• Maya Wong
• Franklin Woo, D.D.S.
• Craig Woodfin
• Rachel Woodie, RADT
• Aleisha Jenee' Woods, CNM
• Eja Woods
• Savannah Leann Woods

• Otolaryngology Physician in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.