Wishing U Well Medical Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

766369-26 Issued in CA

Legal business name

WISHING U WELL MEDICAL INC

Practice address

2217 Plaza Dr Ste 102
Rocklin, CA 95765-4421

Phone

(916) 234-0096

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Jeremy Perkins

Title

Executive Chairman of the Board

Phone

(916) 234-0096

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1053412122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 PLAZA DR STE 102",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957654421",
            "telephone_number": "916-234-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 PLAZA DR STE 102",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957654421",
            "telephone_number": "916-234-0096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3005 Douglas Blvd",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956615720",
            "country_code": "US",
            "telephone_number": "916-234-0096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WISHING U WELL MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "EXECUTIVE CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "916-234-0096"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "766369-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME02796F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Marie Wilson, CMT
• Kelly Jay Wilson, DDS
• Madison Wilson, CMT
• Rachel Wilson
• Khaing Khaing Win, MD
• Sue Ann Wissler, PAC
• Mary Lee Withey
• Traci Witt, LMFT
• Zaira Wong Lara
• A Wong Jr.

• Durable Medical Equipment & Medical Supplies in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.