K. Wensley. Michael MD, PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

K. WENSLEY. MICHAEL MD, PC

Practice address

1601 Dove St Ste 170
Newport Beach, CA 92660-1421

Phone

(949) 674-9081

Fax

(209) 203-1036

NPI assigned

Jul 29, 2024

Organization subpart

Yes

Parent organization

MICHAEL KEITH WENSLEY MD INC A MEDICAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

Tammy Knickerbocker, OTHER

Title

Manager

Phone

(949) 467-9081

Specialties & licenses 1

Addresses

Part of

Michael Keith Wensley MD Inc a Medical Corporation

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Michael Keith Wensley MD Inc a Medical Corporation

  • Specialist
  • Newport Beach, CA
  • NPI 1861721250
  NPPES parent name

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1245069277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601421",
            "telephone_number": "949-674-9081",
            "fax_number": "209-203-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601421",
            "telephone_number": "949-674-9081",
            "fax_number": "209-203-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. WENSLEY. MICHAEL MD, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHAEL KEITH WENSLEY MD INC A MEDICAL CORPORATION",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "KNICKERBOCKER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "949-467-9081",
        "authorized_official_credential": "OTHER"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelli Junker, DDS
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• Ronald Allen Jurgensen, DDS
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• Douglas G Kahn, MD
• Ashton A. Kaidi, M.D.
• Charlotte Suzanne Kalb, AGNP-BC, PMHNP-BC
• Gavin Kam, DPT
• Kamaldeep Singh Chiropractic Inc

• General Practice Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.