Individual provider Active NPI

Vanessa Lynn Werlla, M.D.

  • Psychiatry Physician
  • Tulsa, OK
National Provider Identifier
1164587234
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OK13374 Issued in OK
Practice address
1707 E. 43Rd St.
Tulsa, OK 74105
Phone
(918) 712-7488
Fax
(918) 712-7404
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OK13374 OK Primary

Addresses

Primary practice location

1707 E. 43Rd St.
Tulsa, OK 74105

Mailing address

1707 E. 43Rd St.
Tulsa, OK 74105
Phone (918) 712-7488

Other identifiers 1

IdentifierTypeStateIssuer
1113374MedicaidOK

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
OK13374OKMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1164587234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 E. 43RD ST.",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74105",
            "telephone_number": "918-712-7488",
            "fax_number": "918-712-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 E. 43RD ST.",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74105",
            "telephone_number": "918-712-7488",
            "fax_number": "918-712-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERLLA",
        "first_name": "VANESSA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "OK13374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1113374",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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.