Individual provider Active NPI

Mary Elizabeth Geraldine Wheeldon, NP-C

  • Nurse Practitioner
  • Midland, MI
National Provider Identifier
1275660466
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704261842 Issued in MI
Practice address
4401 N Campus Ridge Dr
Ste 2450
Midland, MI 48640-6112
Phone
(989) 839-1386
Fax
(989) 839-3324
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 47024261842 MI
Gerontology Registered Nurse 163WG0600X 69352 CO
Nurse Practitioner 363L00000X 4704261842 MI Primary

Addresses

Primary practice location

4401 N Campus Ridge Dr
Ste 2450
Midland, MI 48640-6112

Mailing address

4401 N Campus Ridge Dr
Ste 2450
Midland, MI 48640-6112
Phone (989) 839-1386

Other identifiers 1

IdentifierTypeStateIssuer
1275660466MedicaidMI

Other names 1

  • Meg Wheeldon Other name

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
69352COMDGerontology Registered Nurse
47024261842MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care of Colorado, PC PastSince Sep 1, 2010 Accepting new patients

Organizations & group practices 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1275660466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 N CAMPUS RIDGE DR",
            "address_2": "STE 2450",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406112",
            "telephone_number": "989-839-1386",
            "fax_number": "989-839-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 N CAMPUS RIDGE DR",
            "address_2": "STE 2450",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406112",
            "telephone_number": "989-839-1386",
            "fax_number": "989-839-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELDON",
        "first_name": "MARY ELIZABETH",
        "middle_name": "GERALDINE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "47024261842",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "CO",
            "license": "69352",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704261842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275660466",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEG",
            "last_name": "WHEELDON",
            "credential": "NP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.