Active NPI
Frederick P Wener, MD
- Orthopaedic Surgery Physician
- Smyrna, GA
National Provider Identifier
1124104377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- GA27688
- Practice address
- 3969 South Cobb Drive
Suite 108
Smyrna, GA 30080 - Phone
- (770) 436-0041
- Fax
- (770) 436-0335
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | GA27688 | GA | Primary |
Addresses
Primary practice location
3969 South Cobb Drive
Suite 108
Smyrna, GA 30080
Mailing address
3969 South Cobb Drive
Suite 108
Smyrna, GA 30080
Phone (770) 436-0041
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00325025A | Medicaid | GA | |
| 0004049022 | Other | AETNA | |
| 52159038 | Other | GA | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140402001311 | GA | Practitioner - Orthopedic Surgery | 2163603192 | Practice locations: Smyrna, GA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GA27688 | GA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124104377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3969 SOUTH COBB DRIVE",
"address_2": "SUITE 108",
"city": "SMYRNA",
"state": "GA",
"postal_code": "30080",
"telephone_number": "770-436-0041",
"fax_number": "770-436-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3969 SOUTH COBB DRIVE",
"address_2": "SUITE 108",
"city": "SMYRNA",
"state": "GA",
"postal_code": "30080",
"telephone_number": "770-436-0041",
"fax_number": "770-436-0335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENER",
"first_name": "FREDERICK",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "GA",
"license": "GA27688",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00325025A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0004049022",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "52159038",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
- Wellstar Medical Group, LLC (WellStar Smyrna Primary Care Center)
- Wellstar Rheumatology, LLC
- Wellstar Smyrna Primary Care Center, LLC
- Wellstreet of Georgia PC (Piedmont Urgent Care by Wellstreet)
- Wellstreet of Georgia PC (Piedmont Urgentcare by Wellstreet)
- Samantha Nicole Werkheiser, PA-C
- West Atlanta OB-GYN Inc
- West Atlanta Women's Health, LLC
- West Cobb Counseling Center, Inc.
- West Vinings Pediatric Group, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.