SAMUEL BRYAN WOOD NPI 1154835197

NPI Information

  • NPI: 1154835197
  • Provider Name: SAMUEL BRYAN WOOD
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: CORNER OF ROUTE N12 AND N7
    FORT DEFIANCE, AZ
    ZIP 86504
  • Phone: (928) 729-8600

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NPI Details

Samuel Bryan Wood is a family nurse practitioner in Fort Defiance, AZ. Samuel Bryan Wood NPI is 1154835197. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ
ZIP 86504
Phone: (928) 729-8600

The NPI 1154835197 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Emergency department visit for problem of moderate severity (HCPCS:99283)
  • Emergency department visit for life threatening or functioning severity (HCPCS:99285)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only (HCPCS:93010)
  • Emergency department visit for problem of high severity (HCPCS:99284)
  • Emergency department visit for problem of mild to moderate severity (HCPCS:99282)

The enumeration date for this NPI number is 11/29/2017 and was last updated on 10/28/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1207PE0004XEmergency MedicineEmergency Medical Services00000000000VIRGINIANo
2363LA2100XNurse PractitionerAcute Care000000000000VIRGINIANo
3363LC0200XNurse PractitionerCritical Care Medicine000000000000VIRGINIANo
4363LF0000XNurse PractitionerFamilyAPN.0997339-NPCOLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100000000000MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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