MR. RONALD JAY JR. WOODALL (RN NPP) – Acute Care Nurse Practitioner, NPI 1629335948

MR. RONALD JAY JR. WOODALL (RN NPP) is a healthcare provider. based in Flint, Michigan. specializing in Acute Care Nurse Practitioner. They hold the professional credentials RN NPP. They hold a License No. 4704201855 (MI). The NPI Number for MR. RONALD JAY JR. WOODALL (RN NPP) is 1629335948

Main info

Male
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
MR. RONALD JAY JR. WOODALL (RN NPP)
NPI
1629335948
Phone
Not provided
Address
401 S BALLENGER HWY
Enumeration Date
12 April 2012
Last Update Date
17 January 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2484844300
Graduation Year
2011 (15 years ago)
PAC ID
3476626177
Group Practice PAC ID
3971416082
Professional Enrollment ID
I20120511000539
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for MR. RONALD JAY JR. WOODALL (RN NPP)

  • 401 S BALLENGER HWY

    FLINT, MI 485323638

    Phone:

    Type: Mailing

  • 38770 GARFIELD RD

    CLINTON TOWNSHIP, MI 480386620

    Phone: (586) 421-4204

    Fax: (586) 421-4222

    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: 2012-05-11

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
I20120511000539INurse PractitionerMITBD

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 48532)

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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: 3971416082View full group profile
NameSpecialtyState
Internal MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Family PracticeMI
Emergency MedicineIL
-GA
Emergency MedicineMI
Emergency MedicineMI
Physician AssistantMI
-MI

Reviews

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Frequently asked questions

Is MR. RONALD JAY JR. WOODALL (RN NPP) listed with a National Provider Identifier?
Yes — MR. RONALD JAY JR. WOODALL (RN NPP) has NPI 1629335948 on file in the registry.
Would MR. RONALD JAY JR. WOODALL (RN NPP) appear as active to a payer?
You can treat MR. RONALD JAY JR. WOODALL (RN NPP) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MR. RONALD JAY JR. WOODALL (RN NPP)?
MR. RONALD JAY JR. WOODALL (RN NPP)'s record emphasizes Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Michigan is MR. RONALD JAY JR. WOODALL (RN NPP) registered?
Use Flint, Michigan as the headline location for MR. RONALD JAY JR. WOODALL (RN NPP) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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