Active NPI
Wendy Ann Dorminey, PHARM D CDM
- Pharmacist
- Lake Park, GA
National Provider Identifier
1235222415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH020837
- Practice address
- 1016 Lakes Blvd
Lake Park, GA 31636 - Phone
- (229) 559-9398
- Fax
- (229) 559-9408
- NPI assigned
- Oct 2, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH020837 | GA | Primary |
Addresses
Primary practice location
1016 Lakes Blvd
Lake Park, GA 31636
Mailing address
5409 Francis Dr
Lake Park, GA 31636
Phone (229) 559-1318
Other names 1
- Ms. Wendy Ann Kuter
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH020837 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Park Pharmacy LLC | Past | Accepting new patients | |
| Lake Park Pharmacy, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lake Park Pharmacy
- Durable Medical Equipment & Medical Supplies
- Lake Park, GA
- NPI 1528245883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235222415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5409 FRANCIS DR",
"city": "LAKE PARK",
"state": "GA",
"postal_code": "31636",
"telephone_number": "229-559-1318",
"fax_number": "229-559-9408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 LAKES BLVD",
"city": "LAKE PARK",
"state": "GA",
"postal_code": "31636",
"telephone_number": "229-559-9398",
"fax_number": "229-559-9408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORMINEY",
"first_name": "WENDY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PHARM D CDM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH020837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "WENDY",
"last_name": "KUTER",
"middle_name": "ANN",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lake Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.