Active NPI
Gretchen Renee Wellman, C.O.
- Orthotist
- Anchorage, AK
National Provider Identifier
1235480385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- Practice address
- 3400 Latouche St
Suite 100
Anchorage, AK 99508-4208 - Phone
- (907) 561-1777
- Fax
- (907) 561-2157
- NPI assigned
- Sep 28, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | Primary | ||
| Prosthetist | 224P00000X |
Addresses
Primary practice location
3400 Latouche St
Suite 100
Anchorage, AK 99508-4208
Mailing address
3400 Latouche St
Suite 100
Anchorage, AK 99508-4208
Phone (907) 561-1777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PO0012 | Medicaid | AK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1235480385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 LATOUCHE ST",
"address_2": "SUITE 100",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084208",
"telephone_number": "907-561-1777",
"fax_number": "907-561-2157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 LATOUCHE ST",
"address_2": "SUITE 100",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084208",
"telephone_number": "907-561-1777",
"fax_number": "907-561-2157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLMAN",
"first_name": "GRETCHEN",
"middle_name": "RENEE",
"credential": "C.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-28",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": null,
"license": null,
"primary": true
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PO0012",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.