Individual provider Active NPI

Jennifer Lynn Wehberg, M.D.

  • Pediatrics Physician
  • Salisbury, MD
National Provider Identifier
1083705198
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0047664 Issued in MD
Practice address
1415 Wesley Dr
Salisbury, MD 21801-7130
Phone
(410) 912-7000
Fax
(410) 912-4202
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0047664 MD Primary

Addresses

Primary practice location

1415 Wesley Dr
Salisbury, MD 21801-7130

Mailing address

1415 Wesley Dr
Suite 302
Salisbury, MD 21801-7130
Phone (410) 912-7000

Other identifiers 1

IdentifierTypeStateIssuer
421990200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0047664MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Pediatrics LLC Pediatrics Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1415 Wesley Dr
Salisbury, MD 21801
Phone (410) 546-8036

1415 Wesley Dr
Ste 302
Salisbury, MD 21801

Interoperability endpoints

  • Direct secure messaging: jennifer.wehberg@gatewaypeds.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1083705198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 WESLEY DR",
            "address_2": "SUITE 302",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017130",
            "telephone_number": "410-912-7000",
            "fax_number": "410-912-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WESLEY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017130",
            "telephone_number": "410-912-7000",
            "fax_number": "410-912-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHBERG",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0047664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421990200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.