Peter G Wernicki M D P a

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PETER G WERNICKI M D P A

Doing business as

Pro Sports

Practice address

787 37TH St Ste E200
Vero Beach, FL 32960-7306

Phone

(772) 978-7808

Fax

(772) 978-9320

NPI assigned

Jul 3, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Amanda P Mullikin

Title

Admin Assistant

Phone

(772) 978-7808

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pro Sports Doing business as

Practitioners 3

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

• Jennifer L Lang, PA-C

  • Surgical Physician Assistant
  • Palm Bay, FL
  • NPI 1417912494
  NPD (past)
• Thomas David Snyder, PA-C

  • Surgical Physician Assistant
  • Bradenton, FL
  • NPI 1780648949
  NPD (past)
• Tom C Kaiser, PA-C

  • Physician Assistant
  • Chattanooga, TN
  • NPI 1578515219
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1063441731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 37TH ST STE E200",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607306",
            "telephone_number": "772-978-7808",
            "fax_number": "772-978-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 37TH ST STE E200",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607306",
            "telephone_number": "772-978-7808",
            "fax_number": "772-978-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER G WERNICKI M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "MULLIKIN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMIN ASSISTANT",
        "authorized_official_telephone_number": "772-978-7808",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266151900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "45408",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro Sports",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pro Sports",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharon Perry, OTR/L
• Stephanie Perry
• Theodore G Perry, MD
• Nancy Ann Peshke, PTA
• Peter a Gold Psy D P a
• Arley A. Peter, M.D.
• John Peter Petersen, M.D.
• Julia Peterson, M.S., CFY-SLP
• Leuna Petitval
• Fred J Petrilla Jr., PHD

• Orthopaedic Surgery Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.