DR. G. MARTIN WOODARD (NPI# 1881749539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881749539 |
| Entity Type | Individual |
| Full Name | DR. G. MARTIN WOODARD |
| Credential | PH.D. |
| Practice Address |
2711 Breezewood Ave Suite A - 5 Fayetteville NC 28303-5504 |
| Practice Telephone | 9107038551 |
| Practice Fax Number | 9107038551 |
| Mailing Telephone | 9107038551 |
| Mailing Fax Number | 9107038556 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 3635 | NC | Behavioral Health & Social Service Providers |
| N | 103G00000X | Clinical Neuropsychologist | 012695 | NY | Behavioral Health & Social Service Providers |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
3635 | NC | Behavioral Health & Social Service Providers |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
012695 | NY | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
3635 | NC | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
012695 | NY | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
3635 | NC | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
012695 | NY | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
012695 | NY | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
3635 | NC | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
012695 | NY | Behavioral Health & Social Service Providers |
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
3635 | NC | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 3635 | NC | Behavioral Health & Social Service Providers |
| Street Address |
2711 BREEZEWOOD AVE SUITE A - 5 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-5504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568616753 | Brian Edward Rixon | Counselor | 2711 Breezewood Ave, Fayetteville, NC 28303-5504 | 2008-11-14 |
| 1457486797 | Kidspeace National Centers of North America Inc | Community/Behavioral Health | 2711 Breezewood Ave, Fayetteville, NC 28303-5504 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538215660 | Ronald Eugene Mcinroe | Clinical Neuropsychologist | 217 North East, Fayetteville, AR 72701 | 2007-01-25 |
| 1194816512 | James W Mikesell | Clinical Neuropsychologist | 7000 E Genesee St Bldg C, Fayetteville, NY 13066 | 2006-09-28 |
| 1700802485 | James M Fuendeling | Clinical Neuropsychologist | 2013 N Green Acres Rd, Suite C, Fayetteville, AR 72703-2619 | 2006-07-14 |
| 1649205006 | Anne Ward Stevens | Clinical Neuropsychologist | 86 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2006-07-12 |
| 1871527267 | Harvey E Chambers | Clinical Neuropsychologist | 2592 N Gregg Ave Ste 16, Fayetteville, AR 72703-5541 | 2006-07-10 |
| 1447202809 | Daniel J Johnson | Clinical Neuropsychologist | 1100 North College Ave, Veteran Health Care System of The Ozarks, Fayetteville, AR 72703 | 2006-05-16 |
| 1962476010 | Fred Harry Brown Jr. | Clinical Neuropsychologist | 268 Waxhaw St, Fayetteville, NC 28314-8628 | 2006-02-15 |
| 1093716672 | Elizabeth Ann Gamble | Clinical Neuropsychologist | 559 Executive Pl Ste 102, Fayetteville, NC 28305-5154 | 2005-08-09 |
| 1053830315 | Fayetteville Neuropsychology Pllc | Clinical Neuropsychologist | 559 Executive Pl Ste 102, Fayetteville, NC 28305-5154 | 2017-09-18 |
| 1205375250 | Gene Chambers Phd Pllc | Clinical Neuropsychologist | 2592 N Gregg Ave, Ste 16, Fayetteville, AR 72703-5543 | 2017-02-22 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on DR. G. MARTIN WOODARD.
| 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.