NPIMap

Organization Active NPI

Woodson Dermatology

  • Dermatology Physician
  • Henderson, NV
National Provider Identifier
1942343900
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
7014 Issued in NV
Legal business name
WOODSON DERMATOLOGY
Practice address
229 N Pecos Rd Ste 100
Henderson, NV 89074-7364
Phone
(702) 367-6370
Fax
(702) 433-4238
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Dr. Johnnie M. Woodson Jr., M.D.
Title
Medical Director
Phone
(702) 367-6370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 7014 NV Primary

Addresses

Primary practice location

229 N Pecos Rd Ste 100
Henderson, NV 89074-7364

Mailing address

229 N Pecos Rd Ste 100
Henderson, NV 89074-7364
Phone (702) 367-6370

National Provider Directory

National Provider Directory

Locations

229 N Pecos Rd
Ste 100
Henderson, NV 89074
Phone (702) 367-6370

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1942343900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 N PECOS RD STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747364",
            "telephone_number": "702-367-6370",
            "fax_number": "702-433-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 N PECOS RD STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747364",
            "telephone_number": "702-367-6370",
            "fax_number": "702-433-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSON DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "WOODSON",
        "authorized_official_first_name": "JOHNNIE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-367-6370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NV",
            "license": "7014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.