Mark A Wulff, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

105280 Issued in MO

Practice address

3101 Broadway Blvd
Kansas City, MO 64111-2659

Phone

(816) 960-3060

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1043259351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BROADWAY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112659",
            "telephone_number": "816-960-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BROADWAY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112659",
            "telephone_number": "816-960-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WULFF",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MO",
            "license": "105280",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "105280",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "105280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207748617",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wubbenhorst & Wubbenhorst Inc
• Wubbenhorst & Wubbenhorst, Inc.
• Wubbenhorst & Wubbenhorst, Inc.
• John Michael Wubbenhorst Sr., MS
• Jennifer A Wulfert, APNP
• Megan Nicole Wyant
• Anastasia Wyatt, FNP-BC
• Jennifer Wyatt, LAC
• Hannah Jo Wycuff
• Mary Jane Wydick, RN

• Pediatrics Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.