Active NPI
Wellway Medical P.a.
- Internal Medicine Physician
- Plymouth, MN
National Provider Identifier
1063170785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- WELLWAY MEDICAL P.A.
- Practice address
- 2905 Northwest Blvd Ste 230
Plymouth, MN 55441-2644 - Phone
- (612) 367-4824
- NPI assigned
- Nov 30, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Susan Echt Ritter, MD
- Title
- Owner
- Phone
- (303) 229-8345
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
2905 Northwest Blvd Ste 230
Plymouth, MN 55441-2644
Mailing address
2905 Northwest Blvd Ste 230
Plymouth, MN 55441-2644
Phone (612) 367-4824
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Raintree | Direct |
National Provider Directory
National Provider DirectoryLocations
2905 Northwest Blvd
Ste 230
Plymouth, MN 55441
Phone (612) 367-4822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638230400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638230400000",
"number": "1063170785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2905 NORTHWEST BLVD STE 230",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554412644",
"telephone_number": "612-367-4824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2905 NORTHWEST BLVD STE 230",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554412644",
"telephone_number": "612-367-4824"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLWAY MEDICAL P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2021-11-30",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A",
"authorized_official_last_name": "RITTER",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "ECHT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "303-229-8345",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Raintree",
"affiliation": "N",
"endpointDescription": "EMR",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2905 Northwest Blvd Ste 230",
"city": "Plymouth",
"state": "MN",
"country_code": "US",
"postal_code": "554412644",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.