Anthony Donald Wendorf, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5977-27 Issued in WI

Practice address

840 Lake Avenue, Suite 101
Racine, WI 53403-1550

Phone

(262) 634-8688

Fax

(262) 634-7547

NPI assigned

May 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Erc Wisconsin, LLC

  • Adult Mental Health Clinic/Center
  • Wauwatosa, WI
  • NPI 1730853870
  NPD (past)
• Racine Psychological Services, Inc.

  • Adult Mental Health Clinic/Center
  • Racine, WI
  • NPI 1275586323
  NPD (past)
• The Redi Clinic of Wauwatosa, SC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wauwatosa, WI
  • NPI 1043228505
  NPD (past)
• Wisconsin Geriatric Psychological Services SC

  • Psychologist
  • Milwaukee, WI
  • NPI 1538451075
  NPD (past)

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1104052554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 ASPEN ST",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530389454",
            "telephone_number": "262-719-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 LAKE AVENUE, SUITE 101",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031550",
            "telephone_number": "262-634-8688",
            "fax_number": "262-634-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDORF",
        "first_name": "ANTHONY",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-29",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "5977-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Monica Weber, LCSW
• Wegner Vision Clinic, SC
• Jon Robert Wegner, O.D.
• Robert L Wegner, O.D.
• Angela Wells, PA-C
• Brandon Wendt
• Taylor A Werlinger, LPC
• Callie Wessel, PHARMD
• Michael Robert Westman, D.D.S., M.S.
• WFHC - All Saints

• Clinical Psychologist in Racine, WI
• Providers in Racine, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.