Wolverine Healthcare LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

WOLVERINE HEALTHCARE LLC

Practice address

82 Wendell Ave Ste 100
Pittsfield, MA 01201-7066

Phone

(617) 517-6340

Fax

(423) 301-6604

NPI assigned

Feb 15, 2025

Organization subpart

No

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

Authorized official

Name

Ethan Slabaugh, DNP, FNP-BC, BSN, RNNPI 1134849326

Title

Nurse Practitioner

Phone

(617) 517-6340

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ethan Thomas Slabaugh, DNP

  • Nurse Practitioner
  • Pittsfield, MA
  • NPI 1134849326
  NPD Authorized official

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

{
    "created_epoch": "1739577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1043015837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 WENDELL AVE STE 100",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012017066",
            "telephone_number": "617-517-6340",
            "fax_number": "423-301-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 WENDELL AVE STE 100",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012017066",
            "telephone_number": "617-517-6340",
            "fax_number": "423-301-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLVERINE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-15",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "SLABAUGH",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "617-517-6340",
        "authorized_official_credential": "DNP, FNP-BC, BSN, RN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Wnuk
• Charles I Wohl, MD FACP
• Jennifer M Wojtkowski, R.D., L.D.N.
• Michaelene Wojtkowski
• Ana Maya Wolf, LICSW
• Autumn Marie Wood, BA, CADC
• Emily Wood
• Jenifer Amanda Wood
• Kelsey Whytock Wood, MD
• Lauren Wood, CNP

• Nurse Practitioner in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.