Stephanie M Woodfin, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

5101019047 Issued in MI

Practice address

121 S Garfield Ave
Ste a
Traverse City, MI 49686-2967

Phone

(231) 943-2328

Fax

(231) 943-2327

NPI assigned

Jan 5, 2007

Last updated

Jun 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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 Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Berkeley Therapy Institute

  • Psychiatry Physician
  • Berkeley, CA
  • NPI 1255497814
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1932257250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S GARFIELD AVE",
            "address_2": "STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862967",
            "telephone_number": "231-943-2328",
            "fax_number": "231-943-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S GARFIELD AVE",
            "address_2": "STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862967",
            "telephone_number": "231-943-2328",
            "fax_number": "231-943-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODFIN",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A9002",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101019047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "W6164K",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Jane Wonnacott
• Laura Wood, LMT
• Shelly J Wood, LMSW
• Richard A Woodbury, M.D.
• Dawn Marie Woodcox, LPN
• Kori Lyn Woodruff, MSN, RN, NP-C
• Woodward Detroit CVS LLC (CVS Pharmacy # 06843)
• Woodward Detroit CVS LLC (CVS Pharmacy #16197)
• Susan Wooton, LPC
• Kendra G Worden, MSN,FNP-C

• Psychiatry Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.