Organization Active NPI

DRS. Woodall, Wilson & Manley, LLP

  • Family Medicine Physician
  • Barnesville, GA
National Provider Identifier
1881862191
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
022917 Issued in GA
Legal business name
DRS. WOODALL, WILSON & MANLEY, LLP
Practice address
101 Houston St
Barnesville, GA 30204-1660
Phone
(770) 358-1961
NPI assigned
Feb 20, 2008
Last updated
Feb 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Dr. Lee Woodall, M.D.NPI 1023105723
Title
Partner, Physician
Phone
(770) 358-1961

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 022917 GA Primary

Addresses

Primary practice location

101 Houston St
Barnesville, GA 30204-1660

Mailing address

101 Houston St
Barnesville, GA 30204-1660

Other identifiers 1

IdentifierTypeStateIssuer
300031017AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000944 GA Part B Supplier - Clinic/Group Practice 0446248629 Receives reassigned benefits from 6 practitioners
Practice locations: Barnesville, GA

National Provider Directory

National Provider Directory

Locations

101 Houston St
Barnesville, GA 30204
Phone (706) 358-1961

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1881862191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOUSTON ST",
            "city": "BARNESVILLE",
            "state": "GA",
            "postal_code": "302041660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOUSTON ST",
            "city": "BARNESVILLE",
            "state": "GA",
            "postal_code": "302041660",
            "telephone_number": "770-358-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. WOODALL, WILSON & MANLEY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "WOODALL",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "PARTNER, PHYSICIAN",
        "authorized_official_telephone_number": "770-358-1961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "022917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300031017A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barnesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.