NPIMap

Organization Active NPI

Wendy Wigmore

  • Durable Medical Equipment & Medical Supplies
  • Vacaville, CA
National Provider Identifier
1245230424
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
103834 Issued in CA
Legal business name
WENDY WIGMORE
Practice address
506 Main St
Vacaville, CA 95688-3912
Phone
(707) 446-7014
Fax
(707) 446-1871
NPI assigned
Jul 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Wendy A Wigmore, RN
Title
Owner
Phone
(707) 446-7014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 103834 CA Primary

Addresses

Primary practice location

506 Main St
Vacaville, CA 95688-3912

Mailing address

506 Main St
Vacaville, CA 95688-3912
Phone (707) 446-7014

Other names 1

  • Jackson Medical Supply Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jackson Medical Supply3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1245230424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 MAIN ST",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956883912",
            "telephone_number": "707-446-7014",
            "fax_number": "707-446-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MAIN ST",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956883912",
            "telephone_number": "707-446-7014",
            "fax_number": "707-446-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENDY WIGMORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "WIGMORE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-446-7014",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "103834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.