NPIMap

Organization Active NPI

Jerry D Wood

Doing business as Jerry Wood, MD

  • Specialist
  • Livingston, TX
National Provider Identifier
1922294032
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G0304 Issued in TX
Legal business name
JERRY D WOOD
Doing business as
Jerry Wood, MD
Practice address
219 North Eastwood Ave
Livingston, TX 77351
Phone
(936) 327-7147
Fax
(936) 327-6234
NPI assigned
Sep 21, 2007
Last updated
Jun 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Authorized official

Name
Dr. Jerry D Wood, MDNPI 1508866450
Title
Owner
Phone
(936) 327-7147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G0304 TX Primary

Addresses

Primary practice location

219 North Eastwood Ave
Livingston, TX 77351

Mailing address

219 North Eastwood Ave
Livingston, TX 77351
Phone (936) 327-7147

Other identifiers 2

IdentifierTypeStateIssuer
00N68XOtherTXBLUECROSS BLUE SHIELD
093953001MedicaidTX

Other names 1

  • Jerry Wood, MD Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1922294032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 NORTH EASTWOOD AVE",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "77351",
            "telephone_number": "936-327-7147",
            "fax_number": "936-327-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 NORTH EASTWOOD AVE",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "77351",
            "telephone_number": "936-327-7147",
            "fax_number": "936-327-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY D WOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-327-7147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "G0304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "00N68X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093953001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jerry Wood, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livingston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.