Vicki L Wooll, MD MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M8030 Issued in ID

Practice address

1281 E. Iron Eagle Dr.
Eagle, ID 83616

Phone

(208) 939-5535

Fax

(208) 939-5536

NPI assigned

May 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 20, 2023 through Oct 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1922053172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 E. IRON EAGLE DR.",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "83616",
            "telephone_number": "208-939-5535",
            "fax_number": "208-939-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 E. IRON EAGLE DR.",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "83616",
            "telephone_number": "208-939-5535",
            "fax_number": "208-939-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLL",
        "first_name": "VICKI",
        "middle_name": "L",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M8030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80594300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Wong
• Cynthia Woodhouse, MPT
• Natalie Woods
• Staci Celeste Woods, MPT
• Todd R Woodward, PA-C
• Jon Robert Worbets, LPCC
• Morgan Would
• Ashley Wright, MA, CCC-SLP
• Biyu Yang, RDN
• Rachel Yates

• Family Medicine Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.