Individual provider Active NPI

Christie L Woodruff, NP-C

  • Family Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1972544963
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN061075 Issued in GA
Practice address
4371 Clarks Bridge Road
Gainesville, GA 30506
Phone
(770) 983-7987
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN061075 GA Primary

Addresses

Primary practice location

4371 Clarks Bridge Road
Gainesville, GA 30506

Mailing address

4371 Clarks Bridge Rd
Gainesville, GA 30506-3359
Phone (770) 297-7277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061108000062 GA Practitioner - Nurse Practitioner 1557368446 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN061075GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Urological Assoc., P.C. CurrentSince Mar 1, 2012 Accepting new patients
Specialty Spine and Pain PC Past Accepting new patients

Locations

660 Lanier Park Dr
Ste A
Gainesville, GA 30501
Phone (770) 535-0000

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc32209_northeastgeorgiaurologicassoc

Organizations & group practices 2

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1972544963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 CLARKS BRIDGE RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305063359",
            "telephone_number": "770-297-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 CLARKS BRIDGE ROAD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30506",
            "telephone_number": "770-983-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "CHRISTIE",
        "middle_name": "L",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN061075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.