DR. STEPHANIE WOO, OD - NPI NUMBER 1922396076

Summary

Provider Name: DR. STEPHANIE WOO, OD

NPI Number: 1922396076

Clasification: Optometrist (152W00000X)

Organization: STUART ADAMS O.D PC

Address:
383 LAKE HAVASU AVE S
LAKE HAVASU CITY, AZ
ZIP 86403

Phone Number: (928) 680-1144



Detailed Information

DR. Stephanie Woo, OD is an optometrist in Lake Havasu City, AZ with 4 years of experience. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. The assigned NPI number for this provider is 1922396076 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduation Year: 2011

The provider's business address is:

383 LAKE HAVASU AVE S
LAKE HAVASU CITY, AZ
ZIP 86403-368
Phone: (928) 680-1144
Fax: (928) 680-8639

The enumeration date for this NPI number is 7/11/2011 and was last updated on 11/7/2012.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 152W00000X Optometrist 2011019156 MO No
2 152WC0802X Optometrist Corneal and Contact Management 2011019156 MO No
3 152W00000X Optometrist 1812 AZ Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 991630007 MEDICARE PIN MO
2 067820020 MEDICARE PIN MO
3 1922396076 MEDICAID MO
4 Z155372 MEDICARE PIN AZ
5 074730021 MEDICARE PIN MO

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1922396076 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name WOO The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name STEPHANIE The first name of the provider, if the provider is an individual.
5 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
6 Provider Credential Text OD The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
7 Provider First Line Business Practice Location Address 383 LAKE HAVASU AVE S The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name LAKE HAVASU CITY The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name AZ The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 864039368 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 9286801144 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 9286808639 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 7/11/2011 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 11/7/2012 The date that a record was last updated or changed.
16 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 152W00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 2011019156 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 MO The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 N
21 Healthcare Provider Taxonomy Code 2 152WC0802X
22 Provider License Number 2 2011019156 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
23 Provider License Number State Code 2 MO The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
24 Healthcare Provider Primary Taxonomy Switch 2 N
25 Healthcare Provider Taxonomy Code 3 152W00000X
26 Provider License Number 3 1812 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
27 Provider License Number State Code 3 AZ The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
28 Healthcare Provider Primary Taxonomy Switch 3 Y
29 Other Provider Identifier 1 991630007 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier Type Code 1 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier State 1 MO
32 Other Provider Identifier 2 067820020 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier Type Code 2 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
34 Other Provider Identifier State 2 MO
35 Other Provider Identifier 3 1922396076 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
36 Other Provider Identifier Type Code 3 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
37 Other Provider Identifier State 3 MO
38 Other Provider Identifier 4 Z155372 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
39 Other Provider Identifier Type Code 4 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
40 Other Provider Identifier State 4 AZ
41 Other Provider Identifier 5 074730021 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
42 Other Provider Identifier Type Code 5 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
43 Other Provider Identifier State 5 MO
44 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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