Individual provider Active NPI

Jerome Ambrose Wehr, M.D.

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1275508855
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME127069 Issued in FL
Practice address
3301 W Gandy Blvd
Tampa, FL 33611-2931
Phone
(813) 925-1903
Fax
(813) 749-8370
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21600 IA
Family Medicine Physician 207Q00000X ME127069 FL Primary

Addresses

Primary practice location

3301 W Gandy Blvd
Tampa, FL 33611-2931

Mailing address

3301 W Gandy Blvd
Tampa, FL 33611
Phone (813) 925-1903

Other identifiers 2

IdentifierTypeStateIssuer
0031476MedicaidIA
18118OtherIAMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161026002965 FL Practitioner - Family Practice 9931105368 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME127069FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Synergic Healthcare Solutions LLC CurrentSince Jun 1, 2016 Accepting new patients
Synergic Healthcare Solutions LLC Current Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Jun 1, 2016 Accepting new patients
Synergic Healthcare Solutions LLC Current Accepting new patients

Locations

3301 W Gandy Blvd
Tampa, FL 33611
Phone (318) 925-1903

11969 Sheldon Rd
Tampa, FL 33626
Phone (863) 381-5606

5504 Gateway Blvd
Wesley Chapel, FL 33544
Phone (813) 948-5400

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1275508855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W GANDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33611",
            "telephone_number": "813-925-1903",
            "fax_number": "813-749-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W GANDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112931",
            "telephone_number": "813-925-1903",
            "fax_number": "813-749-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHR",
        "first_name": "JEROME",
        "middle_name": "AMBROSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "21600",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME127069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0031476",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "18118",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.