Individual provider Active NPI

Wendi Lanzidelle, CRNA

  • Anesthesiology Physician
  • Cherry Hill, NJ
National Provider Identifier
1174563910
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
10780300 Issued in NJ
Practice address
408 Route 70 E
Cherry Hill, NJ 08034-2409
Phone
(215) 829-3867
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 10780300 NJ Primary

Addresses

Primary practice location

408 Route 70 E
Cherry Hill, NJ 08034-2409

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061019000080 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931105723 Reassigns benefits to 2 organizations
I20111121000793 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931105723 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10780300NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Society Hill Anesthesia Consultants, PC Anesthesiology CurrentSince Jun 27, 1997 Accepting new patients
Mid-Atlantic Anesthesia Associates PA Anesthesiology CurrentSince Aug 16, 2010 Accepting new patients
Society Hill Anesthesia Consultants of New Jersey, PC Anesthesiology CurrentSince Sep 1, 2005 Accepting new patients

Locations

804 Scott Nixon Memorial Dr
Martinez, GA 30907

1600 Haddon Ave
#L
Camden, NJ 08103
Phone (856) 757-3500

408 Route 70 E
Cherry Hill, NJ 08034
Phone (267) 322-7700

140 Mount Holly by Pass
Ste 5
Lumberton, NJ 08048
Phone (609) 267-1555

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1174563910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 ROUTE 70 E",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342409",
            "telephone_number": "215-829-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZIDELLE",
        "first_name": "WENDI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "10780300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.