Jerry Edward Wesch, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4652 Issued in AZ

Practice address

2235 Whippet Way
Sedona, AZ 86336-5905

Phone

(773) 875-5483

NPI assigned

Sep 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1285629261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 WHIPPET WAY",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365905",
            "telephone_number": "773-875-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 WHIPPET WAY",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365905",
            "telephone_number": "773-875-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESCH",
        "first_name": "JERRY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-003536",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IL",
            "license": "071-003536",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "680014846",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Merritt Wanderman, MD FAAOS
• Warren M. Zeitlin, MDPC
• Christopher Warren
• Jaci Watson, MOT
• Erienne Weine, PH.D.
• Jason Allen Wesley, M.D.
• West Sedona Family Practice PLLC
• Kirk Wells Westervelt, DMD
• Geraldine O'Connor Whaley, PHD MFT
• White Buffalo Chiropractic LLC

• Clinical Psychologist in Sedona, AZ
• Providers in Sedona, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.