Woodly Dominique
NPI 1457081507 · Student in an Organized Health Care Education/Training Program · Moultrie, GA
Enrolled with Medicare as Order and Referring Only - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Woodly Dominique is a Student in an Organized Health Care Education/Training Program provider in Moultrie, GA (NPI 1457081507).
Provider details
- NPI number
- 1457081507
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-06-13
- Last updated
- 2022-06-13
- Certified
- 2022-06-13
Frequently asked questions
- What is Woodly Dominique's NPI number?
- Woodly Dominique's National Provider Identifier (NPI) is 1457081507, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Woodly Dominique's specialty?
- Woodly Dominique is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Woodly Dominique located?
- Woodly Dominique's practice location on file with NPPES is 2050 Tallokas Rd, Moultrie, GA 31768-7666.
- What is Woodly Dominique's phone number?
- The practice phone number listed in the NPPES registry for Woodly Dominique is (615) 935-8357.
- Does Woodly Dominique accept Medicare?
- Woodly Dominique is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Woodly Dominique's NPI active?
- Yes — Woodly Dominique's NPI (1457081507) is active in the NPPES registry as of the last update on 2022-06-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.