Organization Active NPI

Wellway Medical P.a.

  • Internal Medicine Physician
  • Plymouth, MN
National Provider Identifier
1063170785
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Nov 30, 2021

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

TypeEndpointUseAffiliation
CONNECT URL Raintree Direct

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.