Organization Active NPI

Wetumpka Hospitalists, P.C.

  • Hospitalist Physician
  • Wetumpka, AL
National Provider Identifier
1235327503
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
WETUMPKA HOSPITALISTS, P.C.
Practice address
74186 Tallassee Hwy
Wetumpka, AL 36092-5643
Phone
(334) 315-0420
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Dr. Ronaldo V. Dejesus, M.D.NPI 1962552448
Title
President
Phone
(334) 315-0420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

74186 Tallassee Hwy
Wetumpka, AL 36092-5643

Mailing address

2257 Taylor Rd
Suite 200
Montgomery, AL 36117-7790
Phone (334) 270-9174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080422000079 AL Part B Supplier - Clinic/Group Practice 1759469430 Receives reassigned benefits from 3 practitioners
Practice locations: Montgomery, AL; Wetumpka, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1235327503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 TAYLOR RD",
            "address_2": "SUITE 200",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177790",
            "telephone_number": "334-270-9174",
            "fax_number": "334-270-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74186 TALLASSEE HWY",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360925643",
            "telephone_number": "334-315-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WETUMPKA HOSPITALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "DEJESUS",
        "authorized_official_first_name": "RONALDO",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-315-0420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wetumpka, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.