Active NPI
Ashton Nanette Wedemeyer, PT
- Physical Therapist
- Cannon Afb, NM
National Provider Identifier
1215447834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-2023-2185
- Practice address
- 124 N Aderholt Loop
Cannon Afb, NM 88103 - Phone
- (575) 904-3506
- NPI assigned
- Oct 10, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60917645 | WA | |
| Physical Therapist | 225100000X | P17340 | NC | |
| Physical Therapist | 225100000X | PT-2023-2185 | NM | Primary |
Addresses
Primary practice location
124 N Aderholt Loop
Cannon Afb, NM 88103
Mailing address
224 W D.L. Ingram Ave
Building 1408
Cannon Afb, NM 88103
Other practice location 1
224 W D.L. Ingram Ave
Building 1408
Cannon AFB, NM 88103
Phone (575) 784-2778
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P17340 | NC | MD | Physical Therapist |
| PT-2023-2185 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710979200000",
"number": "1215447834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 W D.L. INGRAM AVE",
"address_2": "BUILDING 1408",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "88103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 N ADERHOLT LOOP",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "88103",
"telephone_number": "575-904-3506"
}
],
"practiceLocations": [
{
"address_1": "224 W D.L. Ingram Ave",
"address_2": "Building 1408",
"address_purpose": "LOCATION",
"city": "Cannon AFB",
"state": "NM",
"postal_code": "88103",
"country_code": "US",
"telephone_number": "575-784-2778",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEDEMEYER",
"first_name": "ASHTON",
"middle_name": "NANETTE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-10",
"last_updated": "2024-03-21",
"certification_date": "2024-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60917645",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P17340",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "PT-2023-2185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cannon Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.