Active NPI
Diane Lynn Wegelt-Wundrow, CRNA
- Certified Registered Nurse Anesthetist
- Webster, TX
National Provider Identifier
1245294735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 512064
- Practice address
- 333 N Texas Ave
Webster, TX 77598-4966 - Phone
- (281) 335-1700
- Fax
- (281) 335-1708
- NPI assigned
- Apr 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 512064 | TX | Primary |
Addresses
Primary practice location
333 N Texas Ave
Webster, TX 77598-4966
Mailing address
PO Box 4346
Dept 398
Houston, TX 77210-4346
Phone (281) 358-8114
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10069098 | Other | TX | AMERIGROUP |
| P0036114 | Other | TX | RAILROAD MEDICARE |
| 86155U | Other | TX | BLUE CROSS/BLUE SHIELD |
| 033610 | Other | TX | AANA RECERTIFICATION |
Other names 1
- Diane Lynn Wegelt
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)
- Enrolled
- Credentials
- Certified Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245294735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4346",
"address_2": "DEPT 398",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772104346",
"telephone_number": "281-358-8114",
"fax_number": "281-358-0609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N TEXAS AVE",
"city": "WEBSTER",
"state": "TX",
"postal_code": "775984966",
"telephone_number": "281-335-1700",
"fax_number": "281-335-1708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGELT-WUNDROW",
"first_name": "DIANE",
"middle_name": "LYNN",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "512064",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10069098",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P0036114",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "86155U",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AANA RECERTIFICATION",
"identifier": "033610",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DIANE",
"last_name": "WEGELT",
"middle_name": "LYNN",
"credential": "CRNA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Webster, TX
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.