JUDY RONAN WOODBURN (PH.D.) – Clinical Psychologist, NPI 1013937382

JUDY RONAN WOODBURN (PH.D.) is a healthcare provider. based in Bloomington, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. The NPI Number for JUDY RONAN WOODBURN (PH.D.) is 1013937382

Main info

Female
33 Years Of Experience
Accepts Medicare Assignment
Name
JUDY RONAN WOODBURN (PH.D.)
NPI
1013937382
Phone
(309) 268-2172
Address
PO BOX 2451
Enumeration Date
20 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1993 (33 years ago)
PAC ID
3577755578
Group Practice PAC ID
3577515774
Professional Enrollment ID
I20101008000732
Address ID
IL617045402BL3024XSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:19State licenses:0Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

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Provider Addresses for JUDY RONAN WOODBURN (PH.D.)

  • Bloomington Post Office, South Walnut Street, Bloomington, Monroe County, Indiana, 47401, United States

    BLOOMINGTON, IL 617022451

    Phone: (309) 268-2172

    Fax: (309) 268-3649

    Type: Mailing

  • 403, West Virginia Avenue, Highland Historic District, Normal, McLean County, Illinois, 61761, United States

    NORMAL, IL 617613666

    Phone: (309) 268-2910

    Fax: (309) 268-2913

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-10-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101008000732IClinical PsychologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61702)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577515774View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YIL
Nurse PractitionerIL
Clinical PsychologistIL
-FL
Nurse PractitionerIL
Gastroenterology, Internal MedicineWI
P O D I A T R YIL
Hospitalist, Family PracticeTX
-IL
-IL

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Frequently asked questions

Can I verify JUDY RONAN WOODBURN (PH.D.) with an NPI only?
You can start verification with NPI 1013937382 for JUDY RONAN WOODBURN (PH.D.), then check state licensing separately.
Does the file indicate JUDY RONAN WOODBURN (PH.D.) is practicing under active NPI?
Directory data currently reports JUDY RONAN WOODBURN (PH.D.) as active.
What is JUDY RONAN WOODBURN (PH.D.) best known for clinically?
Directory data describes JUDY RONAN WOODBURN (PH.D.) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for JUDY RONAN WOODBURN (PH.D.)?
JUDY RONAN WOODBURN (PH.D.)'s geographic hint is Bloomington, Illinois in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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