DR. ROBERT KELVIN WOODRUFF (NPI# 1336220177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336220177 |
| Entity Type | Individual |
| Full Name | DR. ROBERT KELVIN WOODRUFF |
| Credential | D.P.M., P.A. |
| Practice Address |
3855 Azalea Drive Jackson MS 39206-5105 |
| Mailing Address |
3855 Azalea Dr Jackson MS 39206-5105 |
| Practice Telephone | 6013667063 |
| Practice Fax Number | 6013667860 |
| Mailing Telephone | 6013667063 |
| Mailing Fax Number | 6013667860 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
80102 | MS | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0010072 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497210983 | Robert Jake Woodruff | Specialist/Technologist | 1704 Twining Rd, Willow Grove, PA 19090-3732 | 2019-02-08 |
| 1497250922 | Robert Lincoln Woodruff | Specialist/Technologist | 1050 E Norris Dr Ste 3, Ottawa, IL 61350-1605 | 2018-03-27 |
| 1306850995 | Robert Woodruff | Chiropractor | 352 Main St Ne, Los Lunas, NM 87031-7465 | 2006-07-28 |
| 1073554754 | Robert A Woodruff | Family Medicine | 311 W Main St, Wilburton, OK 74578-4047 | 2006-06-10 |
| 1821081340 | Robert David Woodruff | Optometrist | 2665 Fox Pointe Dr, Columbus, IN 47203-3222 | 2005-08-30 |
| 1194729533 | Robert Everett Woodruff II | Optometrist | 8051 Vesta Ave, Ste 2, Northfield, OH 44067-2044 | 2005-06-13 |
| 1619435583 | Robert Woodruff | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr, Lebanon, OR 97355-3983 | 2019-03-08 |
| 1669513552 | Robert James Woodruff | Orthopaedic Surgery | 7220 Mount Rushmore Rd, Rapid City, SD 57702 | 2007-02-12 |
| 1659454262 | Robert C Woodruff | Specialist | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2006-10-24 |
| 1992810378 | Robert James Woodruff | Physician Assistant | 2211 E Mill Plain Blvd, Vancouver, WA 98661-4329 | 2006-08-19 |
| Street Address |
3855 AZALEA DRIVE |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-5105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477691095 | Julian Sansone, Dpm, PC | Podiatrist | 4 Peacock Ln, Jackson, NJ 08527 | 2007-02-03 |
| 1356615512 | The Wound & Podiatry Center | Podiatrist | 1815 Hospital Dr, Suite 434, Jackson, MS 39204-3425 | 2012-03-05 |
| 1083882385 | Dr Robert Woodruff Dpm Pa | Podiatrist | 3855 Azalea Dr, Jackson, MS 39206-5105 | 2008-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780218289 | Ortho Express Holding Company, LLC | Podiatrist | 3952 N Gloster St Ste C, Tupelo, MS 38804-0913 | 2020-02-24 |
| 1124479100 | Foot and Surgery Clinic, Inc | Podiatrist | 7402 S Siwell Rd, Suite 110, Byram, MS 39272-9386 | 2016-06-30 |
| 1871953877 | Foot and Surgery Clinci, Inc | Podiatrist | 580 S Pear Orchard Rd Apt 312, Ridgeland, MS 39157-4210 | 2016-03-03 |
| 1508161597 | Jla Senior Footcare Ms LLC | Podiatrist | 300 Ark Ln, Petal, MS 39465-3606 | 2011-01-21 |
| 1497905079 | Vershern Edwards | Podiatrist | 297 Hwy 51 Suite C, Ridgeland, MS 39157 | 2008-09-19 |
| 1285827071 | Moss Point Foot Clinic, LLC | Podiatrist | 4316 Mcinnis Ave, Moss Point, MS 39563-2812 | 2007-08-24 |
| 1821208372 | Natchez Podiatry & Foot Surgery Pa | Podiatrist | 228c John R Junkin Dr, Natchez, MS 39120-3822 | 2007-05-23 |
| 1205049657 | Michael L Boykins | Podiatrist | 6800 Old Canton Rd Ste 111, Ridgeland, MS 39157-1254 | 2007-05-08 |
| 1407922867 | Scott Joseph Hanegan | Podiatrist | 1300 25th Ave, Meridian, MS 39301-3916 | 2006-11-28 |
| 1669575668 | Michael Frank De Marco | Podiatrist | 101 Lamar Smith Rd, Poplarville, MS 39470 | 2006-09-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.