Active NPI
Harvey Claude Woodruff III, DDS
- Periodontics
- Hayes, VA
National Provider Identifier
1902826373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 0401003804
- Practice address
- 2654 George Washington Memorial Highway
Hayes, VA 23072 - Phone
- (804) 642-3558
- Fax
- (804) 642-6712
- NPI assigned
- Jul 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 0401003804 | VA | Primary |
Addresses
Primary practice location
2654 George Washington Memorial Highway
Hayes, VA 23072
Mailing address
2654 George Washington Memorial Highway
Hayes, VA 23072
Phone (804) 642-3558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160608001367 | VA | Order and Referring Only - Dentist | 0446408777 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401003804 | VA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902826373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2654 GEORGE WASHINGTON MEMORIAL HIGHWAY",
"city": "HAYES",
"state": "VA",
"postal_code": "23072",
"telephone_number": "804-642-3558",
"fax_number": "804-642-6712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2654 GEORGE WASHINGTON MEMORIAL HIGHWAY",
"city": "HAYES",
"state": "VA",
"postal_code": "23072",
"telephone_number": "804-642-3558",
"fax_number": "804-642-6712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF",
"first_name": "HARVEY",
"middle_name": "CLAUDE",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "VA",
"license": "0401003804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayes, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.