DR. KENDRA SUZANNE WOODS (NPI# 1649581570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649581570 |
| Entity Type | Individual |
| Full Name | DR. KENDRA SUZANNE WOODS |
| Credential | M.D. |
| Practice Address |
415 N 9th St Ste 2w126 Springfield IL 62702-5303 |
| Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
| Practice Telephone | 2175458000 |
| Mailing Telephone | 2175453787 |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-05-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 197494 | PA | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
036-142887 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
415 N 9TH ST STE 2W126 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-5303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437798899 | Audra M Horn | Nurse Practitioner | 415 N 9th St Ste 2w126, Springfield, IL 62702-5303 | 2020-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396144259 | Danyal Thaver | Pediatrics | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2014-08-17 |
| 1669896775 | Pallav Bhattarai | Pediatrics | 759 Chestnut Street, Springfield, MA 01107-1619 | 2014-02-10 |
| 1124223029 | Kimberly Lynn Marohn | Pediatrics | 759 Chestnut St, Springfield, MA 01199-1619 | 2007-06-19 |
| 1578684718 | Michael F Canarie | Pediatrics | 759 Chestnut St, W2810, Springfield, MA 01199-1619 | 2007-04-03 |
| 1497898118 | Dean R Rising | Pediatrics | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2007-02-14 |
| 1336228808 | Kathleen M Ventre | Pediatrics | 759 Chestnut St, W2810, Springfield, MA 01199-1619 | 2006-11-03 |
| 1013011592 | Stephen A Lieberman | Pediatrics | 759 Chestnut St, Springfield, MA 01107-1619 | 2006-09-12 |
| 1336243823 | Christine A Mckiernan | Pediatrics | 759 Chestnut St, Springfield, MA 01107-1619 | 2006-09-12 |
| 1932182656 | Dr Gurpreet S Mander | Pediatrics | 415 N 9th St, Springfield, IL 62702-5317 | 2005-11-28 |
| 1780677732 | Diane C Lipscomb | Pediatrics | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2005-08-24 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.