TAELAH WOOTEN – Student in an Organized Health Care Education/Training Program, NPI 1083292460

TAELAH WOOTEN is a healthcare provider. based in Odessa, Texas. specializing in OBSTETRICS/GYNECOLOGY. The NPI Number for TAELAH WOOTEN is 1083292460

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
TAELAH WOOTEN
NPI
1083292460
Phone
(432) 703-5083
Address
701 W 5TH ST STE 1229
Enumeration Date
29 March 2021
Last Update Date
29 March 2021

Doctor Profile

Medical School Name
KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Secondary Phone
4694765623
Graduation Year
2021 (5 years ago)
PAC ID
3779985494
Group Practice PAC ID
0042643751
Professional Enrollment ID
I20250927000485
Address ID
TX750344066FR5575XPKWY307
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

3,164 OBSTETRICS/GYNECOLOGY in TX

Provider Addresses for TAELAH WOOTEN

  • 701 W 5TH ST STE 1229

    ODESSA, TX 797634206

    Phone: (432) 703-5083

    Mailing address matches the actual address.

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: 2025-09-27

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
I20250927000485IObstetrics/GynecologyTXTBD

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 79763)

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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: 0042643751View full group profile
NameSpecialtyState
Internal MedicineTX
Internal MedicineTX
Family PracticeTX
Family PracticeTX
Family PracticeTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Family PracticeTX
Family PracticeTX
Internal Medicine, Sleep MedicineTX
Sleep Medicine, Internal MedicineNY

Reviews

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Frequently asked questions

How is TAELAH WOOTEN identified in CMS data?
CMS-hosted NPPES data lists TAELAH WOOTEN with NPI 1083292460.
Is TAELAH WOOTEN listed as active for patients and plans?
The listing shows TAELAH WOOTEN as active in the NPI system.
What healthcare role does TAELAH WOOTEN hold?
Scheduling teams often label TAELAH WOOTEN under Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
What address line appears for TAELAH WOOTEN?
TAELAH WOOTEN's geographic hint is Odessa, Texas in our summary view.
Why does TAELAH WOOTEN have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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