Individual provider Active NPI

Wendsore I Gansore

  • Specialist
  • Omaha, NE
National Provider Identifier
1306643317
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
13808 Hillsborough Dr
Omaha, NE 68164-5060
Phone
(402) 419-9419
NPI assigned
Feb 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

13808 Hillsborough Dr
Omaha, NE 68164-5060

Mailing address

13808 Hillsborough Dr
Omaha, NE 68164-5060
Phone (402) 419-9419

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1306643317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13808 HILLSBOROUGH DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681645060",
            "telephone_number": "402-419-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13808 HILLSBOROUGH DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681645060",
            "telephone_number": "402-419-9419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSORE",
        "first_name": "WENDSORE",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.