Active NPI
Martin Woon, PHD
- Clinical Neuropsychologist
- Jackson, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 3982
- Practice address
- 700 W Forest Ave Ste 200
Jackson, TN 38301-3940 - Phone
- (731) 541-9490
- Fax
- (731) 541-9486
- NPI assigned
- Sep 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 36320 | TX | |
| Clinical Neuropsychologist | 103G00000X | 3982 | TN | Primary |
| Psychologist | 103T00000X | 36320 | TX |
Addresses
Primary practice location
700 W Forest Ave Ste 200
Jackson, TN 38301-3940
Mailing address
257 Bancorp South Pkwy
Jackson, TN 38305-7582
Phone (731) 512-1283
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q086560 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000
72 Physicians Dr
Jackson, TN 38305-2070
Phone (731) 541-9490
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.74 of 100
- Quality
- 85.23
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36320 | TX | MD | Pharmacist |
| 3982 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Tennessee Medical Group Inc | Current | Accepting new patients |
Locations
400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410
257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283
72 Physicians Dr
Jackson, TN 38305
Phone (731) 660-6395
620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923
367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000
700 W Forest Ave
Ste 200
Jackson, TN 38301
Phone (731) 423-1267
301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220
Interoperability endpoints
- mwoon27621@directepic.wth.org
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Jackson, TN
- NPI 1053615955
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1902156755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 BANCORP SOUTH PKWY",
"city": "JACKSON",
"state": "TN",
"postal_code": "383057582",
"telephone_number": "731-512-1283",
"fax_number": "731-660-8739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W FOREST AVE STE 200",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013940",
"telephone_number": "731-541-9490",
"fax_number": "731-541-9486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOON",
"first_name": "MARTIN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-19",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "36320",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TN",
"license": "3982",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "36320",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q086560",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.