Christopher J Wenner MD, PA
Organization Active NPI Family Medicine Physician · Cold Spring, MN
NPI 1174762330 · NPPES record last updated Oct 24, 2012
Key facts
- NPI
- 1174762330
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 46428 (MN)
- Legal business name
- CHRISTOPHER J WENNER MD, PA
- Practice address
- 218 Main St
Cold Spring, MN 56320 - Phone
- (320) 685-3020
- Fax
- (320) 685-4462
- NPI assigned
- Feb 11, 2009
- Organization subpart
- No
Authorized official
- Name
- Christopher J Wenner, MD
- Title
- President
- Phone
- (320) 685-3020
Practitioners 5
-
Suzanne Kelly, CNP
-
Heidi Madden, APRN, CNP
-
Michael S Butler, PA-C
-
Janell Wesenberg, MSW, LICSW
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D1097853 | Christopher J Wenner MD PA | Certificate of waiver | Apr 5, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090522000335 | MN | Part B Supplier - Clinic/Group Practice | 4688723521 |
Receives reassigned benefits from 4 practitioners Practice locations: Cold Spring, MN |
National Provider Directory
Locations
24 3rd Ave S
Ste 1
Cold Spring, MN 56320
Phone (320) 685-3020
218 Main St
Cold Spring, MN 56320
Phone (320) 249-3775
Interoperability endpoints
- https://api.platform.athenahealth.com/23532/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 46428 | MN | Yes |
| Primary Care Clinic/Center | 261QP2300X | 46428 | MN |
Addresses
Primary practice location
218 Main St
Cold Spring, MN 56320
Mailing address
218 Main St
Cold Spring, MN 56320
Phone (320) 685-3020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 313613200 | Medicaid | MN |
Other providers in Cold Spring, MN
- Rachel Burg
- Amber Byram
- Centracare Clinic
- Centracare Health-Paynesville LLC
- Child Psychiatric Services
- Cold Spring Chiropractic Center, LTD
- Cold Spring Eye Clinic PA
- Comminty Behavioral Health Hospital-Cold Spring
- Dahl Chiropractic P.a.
- David Glenn Dahl
All providers in Cold Spring, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.