Individual provider Active NPI

Martin Woon, PHD

  • Clinical Neuropsychologist
  • Jackson, TN
National Provider Identifier
1902156755
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3982 Issued in TN
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

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
Q086560MedicaidTN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013001728 TN Practitioner - Clinical Psychologist 4183873904 Reassigns benefits to 1 organization

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
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

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 100Reported as apm
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

LicenseStateTypeSpecialty
36320TXMDPharmacist
3982TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc CurrentSince Jul 15, 2023 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.