Earle G. Woodman, M.D.,P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

26212 Issued in MA

Legal business name

EARLE G. WOODMAN, M.D.,P.C.

Practice address

148 Chestnut St
Needham, MA 02492-2505

Phone

(781) 453-3069

Fax

(781) 453-3660

NPI assigned

Mar 5, 2008

Organization subpart

No

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

Authorized official

Name

Earle G. Woodman, MD

Title

President

Phone

(781) 453-3069

Specialties & licenses 2

Addresses

Other identifiers 5

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1861662868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 CHESTNUT ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922505",
            "telephone_number": "781-453-3069",
            "fax_number": "781-453-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 CHESTNUT ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922505",
            "telephone_number": "781-453-3069",
            "fax_number": "781-453-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLE G. WOODMAN, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "WOODMAN",
        "authorized_official_first_name": "EARLE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-453-3069",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MA",
            "license": "26212",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MA",
            "license": "26212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "C16037",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "66308",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "M18953",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "026212",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9750011",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Duxbury
• John Dwyer
• Kipp Kevin Dye, M.S.P.T.
• Ksera Dyette, PSY.D.
• Amanda Dziura
• Deborah L Ebert Long, MD
• David Eckelkamp, L.M.H.C.
• Jessica Leigh Effren, M.S.
• Emma Ehrenthal
• Melissa Ehrlichman

• Primary Care Clinic/Center in Needham, MA
• Providers in Needham, MA by specialty
• Primary Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.