Womack Primary Medical Care, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

223075 Issued in NY

Legal business name

WOMACK PRIMARY MEDICAL CARE, PLLC

Doing business as

Womack Internal Medicine, PLLC

Practice address

400 Montauk Hwy
Ste 111
West Islip, NY 11795-4429

Phone

(631) 277-0051

Fax

(631) 277-2690

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence H Womack, M.D.NPI 1487659629

Title

Chief Medical Officer

Phone

(631) 277-0051

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Womack Internal Medicine, PLLC Doing business as

Locations

Practitioners 1

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.

• Lawrence H Womack, M.D.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1487659629
  Authorized official Same address or phone

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1902903800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 RAILROAD AVE # 205",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022204",
            "telephone_number": "631-277-0051",
            "fax_number": "631-277-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MONTAUK HWY",
            "address_2": "STE 111",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954429",
            "telephone_number": "631-277-0051",
            "fax_number": "631-277-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMACK PRIMARY MEDICAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "WOMACK",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "631-277-0051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "223075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE",
            "identifier": "3298766",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA HEALTHCARE",
            "identifier": "153114",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02214588",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00165433",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "P2912790",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Womack Internal Medicine, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cheyenne Wilson
• Daniel Mark Wilson Jr., RPA-C
• June Wisniewski
• Kim L. Wist, D.C.
• Stephanie Wohlberg, MS, OTR/L
• Lawrence H Womack, M.D.
• Matthew Leon Woolley, MD
• Stefani T Wren, MD
• Divya Yadlapalli
• Zhanqing Yan, M.D.

• Internal Medicine Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.