Active NPI
Ralph Higgins Wetmore II, PH.D.
- Psychologist
- Tucson, AZ
National Provider Identifier
1265444178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1022
- Practice address
- 1540 N Tucson Blvd
Tucson, AZ 85716-3423 - Phone
- (520) 881-6875
- Fax
- (520) 327-2298
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1022 | AZ | Primary |
Addresses
Primary practice location
1540 N Tucson Blvd
Tucson, AZ 85716-3423
Mailing address
1540 N Tucson Blvd
Tucson, AZ 85716-3423
Phone (520) 881-6875
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0133210 | Other | AZ | BC/BS PROVIDER NUMBER |
| 115718 | Other | AZ | AHCCCS |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1022 | AZ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265444178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 N TUCSON BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857163423",
"telephone_number": "520-881-6875",
"fax_number": "520-327-2298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 N TUCSON BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857163423",
"telephone_number": "520-881-6875",
"fax_number": "520-327-2298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETMORE",
"first_name": "RALPH",
"middle_name": "HIGGINS",
"name_suffix": "II",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "1022",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER NUMBER",
"identifier": "AZ0133210",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "115718",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
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.