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

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 29, 2021PECOS EnrolledAccepts Medicare Assignment

701 W 5TH ST STE 1229, ODESSA, TX 79763(432) 703-5083 Get Directions Write a Review

NPPES record last updated: March 29, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Taelah Wooten NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAELAH WOOTEN (NPI 1083292460) is an individual student in an organized health care education/training program in Odessa, Texas and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Kansas City University Of Med & Biosciences, College Of Osteo Med (2021).

NPPES Registry Identity

NPI1083292460

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameTAELAH WOOTEN

Location Address701 W 5TH ST STE 1229Odessa, TX 79763-4206

Mailing Address701 W 5th St Ste 1229Odessa, TX 79763-4206 · (432) 703-5083

Phone(432) 703-5083

Sole ProprietorNo

Medical School CMSKansas City University Of Med & Biosciences, College Of Osteo MedGraduated 2021

Enumeration DateMarch 29, 2021

NPPES CertifiedMarch 29, 2021

✔ NPI 1083292460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

701 W 5TH ST STE 1229, Odessa, TX 79763

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Taelah Wooten is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779985494

PECOS Enrollment IDI20250927000485

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.