Duane Wooten, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

17126 Issued in AZ

Practice address

515 W Buckeye Rd Ste 306
Phoenix, AZ 85003-2650

Phone

(602) 374-4937

Fax

(602) 388-4261

NPI assigned

Aug 2, 2005

Reactivated

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Valle del Sol, Inc.

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1831344035
  Medicare reassignment NPD
• Valle del Sol, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1174345839
  NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1609300854
  NPD (past)
• Rainbow Medical Group

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1205941093
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992706758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W BUCKEYE RD STE 306",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850032650",
            "telephone_number": "602-374-4937",
            "fax_number": "602-388-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W BUCKEYE RD STE 306",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850032650",
            "telephone_number": "602-374-4937",
            "fax_number": "602-388-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-07-21",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "17126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027011",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0260080",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Woolsey, RN
• Matthew M Woosley, MD
• Wooten & Associates, PLC
• Wooten Naturopathic PLC
• Buffy T. Wooten, PH.D.
• Dyanna Wooten
• Kathleen A Wooten, O.D.
• Tracy Wooten, NMD
• Word Play, LLC
• Sean Word, CPHT-ADV, CSPT

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.