Wensley M Keith MD PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WENSLEY M KEITH MD PC

Practice address

1601 Dove St Ste 170
Newport Beach, CA 92660-1421

Phone

(949) 610-5240

NPI assigned

Aug 27, 2024

Organization subpart

No

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

Authorized official

Name

Tammy Knickerbocker

Title

Manager

Phone

(949) 610-5240

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael K. Wensley, M.D.

  • Specialist
  • West Hollywood, CA
  • NPI 1841336740
  Medicare reassignment NPD

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1174357768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601421",
            "telephone_number": "949-610-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601421",
            "telephone_number": "949-610-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENSLEY M KEITH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-27",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "KNICKERBOCKER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "949-610-5240"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellcentrex LLC
• Michael William Wells, D.D.S.
• James Robert Wendt, M.D.
• Elizabeth Zamierowski Wenger, MA, LMFT
• Wenjing Liu, M.D. Inc.
• Wensley M Keith MD, PC
• Amber Werner, D.C.
• Anna Werner, LVN
• Breeanne Rose Werring
• West Coast Bio Lab LLC

• General Practice Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.