Individual provider Active NPI

James L Woodman, MD

  • Family Medicine Physician
  • Woodstock, IL
National Provider Identifier
1932201555
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036103007 Issued in IL
Practice address
2000 Lake Ave
Woodstock, IL 60098-7401
Phone
(815) 337-1544
Fax
(815) 337-4792
NPI assigned
Sep 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C140113 CA
Family Medicine Physician 207Q00000X C140113 CA
Family Medicine Physician 207Q00000X 036103007 IL Primary

Addresses

Primary practice location

2000 Lake Ave
Woodstock, IL 60098-7401

Mailing address

2000 Lake Ave
Woodstock, IL 60098-7401
Phone (815) 337-1544

Other practice location 1

1340 Charles St
Rockford, IL 61104-2200
Phone (779) 696-5353

Other identifiers 1

IdentifierTypeStateIssuer
036103007MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040402000654 IL Practitioner - Family PracticePractitioner - Other (Physician) 6608868195 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C140113CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Mar 16, 2023 Accepting new patients
Mercy Health System Corporation CurrentSince Apr 20, 2018 Accepting new patients
Mercy Health System Corporation CurrentSince Apr 20, 2018 Accepting new patients

Locations

Carol Stream, IL 60122

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

3922 Mercy Dr
McHenry, IL 60050
Phone (815) 344-4499

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

3401 N Perryville Rd
Rockford, IL 61114

2000 Lake Ave
Woodstock, IL 60098
Phone (815) 337-4116

Organizations & group practices 3

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": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1932201555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 LAKE AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987401",
            "telephone_number": "815-337-1544",
            "fax_number": "815-337-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 LAKE AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987401",
            "telephone_number": "815-337-1544",
            "fax_number": "815-337-4792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Charles St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611042200",
            "country_code": "US",
            "telephone_number": "779-696-5353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODMAN",
        "first_name": "JAMES",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-03",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C140113",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C140113",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

Verify at the official NPI Registry.