Individual provider Active NPI

Melissa Marie Wensing

  • Licensed Practical Nurse
  • Quincy, IL
National Provider Identifier
1194472738
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043090060 Issued in IL
Practice address
639 York St RM 212
Quincy, IL 62301-3919
Phone
(217) 222-6277
Fax
(217) 214-5450
NPI assigned
Mar 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043090060 IL Primary

Addresses

Primary practice location

639 York St RM 212
Quincy, IL 62301-3919

Mailing address

1601 Old South River Rd
Saint Charles, MO 63303-4120
Phone (636) 224-1210

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

State licenses

LicenseStateTypeSpecialty
043090060ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1194472738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OLD SOUTH RIVER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034120",
            "telephone_number": "636-224-1210",
            "fax_number": "636-246-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 YORK ST RM 212",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013919",
            "telephone_number": "217-222-6277",
            "fax_number": "217-214-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENSING",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043090060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.