Active NPI
Cheryl Elaine Wayne, MD
- Pediatrics Physician
- Fort Pierce, FL
National Provider Identifier
1215938519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME0067424
- Practice address
- 1505 Delaware Ave
Fort Pierce, FL 34950-3975 - Phone
- (772) 461-1402
- Fax
- (844) 540-4794
- NPI assigned
- Aug 9, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME0067424 | FL | Primary |
Addresses
Primary practice location
1505 Delaware Ave
Fort Pierce, FL 34950-3975
Mailing address
5827 Corporate Way
West Palm Beach, FL 33407-2000
Phone (561) 844-9443
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 379497100 | Medicaid | FL | |
| 26624 | Other | FL | BS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0067424 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palm Beach Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
| Palm Beach Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Bluebird Kids Health
- Pediatrics Physician
- Loxahatchee Groves, FL
- NPI 1346209244
-
dba Bluebird Kids Health
- Pediatrics Physician
- West Palm Beach, FL
- NPI 1508047952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572220800000",
"number": "1215938519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5827 CORPORATE WAY",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334072000",
"telephone_number": "561-844-9443",
"fax_number": "561-472-9692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 DELAWARE AVE",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349503975",
"telephone_number": "772-461-1402",
"fax_number": "844-540-4794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAYNE",
"first_name": "CHERYL",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-09",
"last_updated": "2019-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME0067424",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "379497100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS",
"identifier": "26624",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.