Individual provider Active NPI

Christene E Wenger

  • Specialist
  • Ravena, NY
National Provider Identifier
1154664456
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
527745111 Issued in VA
Practice address
14379 Route 9W
Circle of Friends
Ravena, NY 12143-0000
Phone
(518) 756-3124
Fax
(518) 756-9476
NPI assigned
Apr 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 527745111 VA Primary

Addresses

Primary practice location

14379 Route 9W
Circle of Friends
Ravena, NY 12143-0000

Mailing address

14379 Route 9W
Circle of Friends
Ravena, NY 12143-0000
Phone (518) 756-3124

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
527745111VAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1154664456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14379 ROUTE 9W",
            "address_2": "CIRCLE OF FRIENDS",
            "city": "RAVENA",
            "state": "NY",
            "postal_code": "121430000",
            "telephone_number": "518-756-3124",
            "fax_number": "518-756-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14379 ROUTE 9W",
            "address_2": "CIRCLE OF FRIENDS",
            "city": "RAVENA",
            "state": "NY",
            "postal_code": "121430000",
            "telephone_number": "518-756-3124",
            "fax_number": "518-756-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "CHRISTENE",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "527745111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravena, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.