Ralf G Wildner, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD060289L Issued in PA

Practice address

500 School St
Clarks Summit, PA 18411-1508

Phone

(570) 586-3587

Fax

(570) 586-0337

NPI assigned

Mar 21, 2006

Last updated

Oct 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Salazar Associates

  • Clinical Social Worker
  • Clarks Summit, PA
  • NPI 1710155643
  NPD (past)
• Tri County Human Services Center Inc

  • Case Management Agency
  • Carbondale, PA
  • NPI 1710186952
  NPD (past)
• Tri County Human Services Center Inc

  dba Maxis Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carbondale, PA
  • NPI 1912966805
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1093774986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NIKELLE LN",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184112866",
            "telephone_number": "570-586-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SCHOOL ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111508",
            "telephone_number": "570-586-3587",
            "fax_number": "570-586-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDNER",
        "first_name": "RALF",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD060289L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101359647",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Marie Watkins, MA, LPC
• Mary Theresa Webb, RD, LDN, CDE
• Elizabeth Weber
• Weis Markets Inc (Weis Pharmacy)
• Joanne G Weiss, MSW LCSW MA MDIV DAR
• Joshua Wilkes, MPT
• Jennifer Williams
• Kathleen Elizabeth Williams
• Santina Williams, MS, NCC, LPC
• Sherry L Winn, O.D.

• Psychiatry Physician in Clarks Summit, PA
• Providers in Clarks Summit, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.