Individual provider Active NPI

Jennifer M Wellman, FNP-BC

  • Family Nurse Practitioner
  • Wheeling, WV
National Provider Identifier
1013298645
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
268729 Issued in OH
Practice address
2115 Chapline St
Wheeling, WV 26003-3859
Phone
(304) 234-8885
Fax
(304) 234-1838
NPI assigned
Sep 9, 2011
Last updated
Mar 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 268729 OH Primary

Addresses

Primary practice location

2115 Chapline St
Wheeling, WV 26003-3859

Mailing address

2115 Chapline St
Wheeling, WV 26003-3859
Phone (304) 234-8885

Other identifiers 2

IdentifierTypeStateIssuer
0054175MedicaidOH
3810021209MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
268729OHMDFamily Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7452/brand/1/csg/1/fhir/r4

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1013298645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 CHAPLINE ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033859",
            "telephone_number": "304-234-8885",
            "fax_number": "304-234-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 CHAPLINE ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033859",
            "telephone_number": "304-234-8885",
            "fax_number": "304-234-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMAN",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "268729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054175",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810021209",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.