Active NPI
Kristie-Lee Wendler, COTA/L
- Skilled Nursing Facility
- Medford, MA
National Provider Identifier
1013388719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 3957
- Practice address
- 200 Governors Ave
Medford, MA 02155-1644 - Phone
- (781) 391-5400
- NPI assigned
- Oct 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 3957 | MA | Primary |
Addresses
Primary practice location
200 Governors Ave
Medford, MA 02155-1644
Mailing address
13 Lakeview Ave
Apartment 2
Reading, MA 01867-3281
Phone (617) 318-7637
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3957 | MA | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444176000000",
"number": "1013388719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 LAKEVIEW AVE",
"address_2": "APARTMENT 2",
"city": "READING",
"state": "MA",
"postal_code": "018673281",
"telephone_number": "617-318-7637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 GOVERNORS AVE",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021551644",
"telephone_number": "781-391-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENDLER",
"first_name": "KRISTIE-LEE",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-07",
"last_updated": "2015-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MA",
"license": "3957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.