Active NPI
Bart R Wendell, PHD
- Psychologist
- Petersham, MA
National Provider Identifier
1174018915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3025
- Practice address
- 153 East St
Petersham, MA 01366-9741 - Phone
- (978) 724-0400
- NPI assigned
- Jun 25, 2018
- Last updated
- Jun 25, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3025 | MA | Primary |
Addresses
Primary practice location
153 East St
Petersham, MA 01366-9741
Mailing address
153 East St
Petersham, MA 01366-9741
Phone (978) 724-0400
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3025 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529884800000",
"number": "1174018915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 EAST ST",
"city": "PETERSHAM",
"state": "MA",
"postal_code": "013669741",
"telephone_number": "978-724-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 EAST ST",
"city": "PETERSHAM",
"state": "MA",
"postal_code": "013669741",
"telephone_number": "978-724-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENDELL",
"first_name": "BART",
"middle_name": "R",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-25",
"last_updated": "2018-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "3025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petersham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.