Timothy A Wenstrom, PSYD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

LP4423 Issued in MN

Practice address

700 1St Ave S
Fargo, ND 58103-1802

Phone

(701) 234-4086

Fax

(701) 234-4024

NPI assigned

Jul 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924
  Medicare reassignment NPD
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1326069667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031929",
            "telephone_number": "701-234-4141",
            "fax_number": "701-234-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 1ST AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031802",
            "telephone_number": "701-234-4086",
            "fax_number": "701-234-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENSTROM",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "LP4423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12155",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764462100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darin Weninger
• Derek Weninger, PA-C
• Sara Wenko
• Jaime Lee Wenner-Windahl, LCSW
• Kallie Jo Wennerberg, AGNP-C
• Nicole Nyleen Wentworth
• Kayla Wentz
• Nina Wentz, CRNA
• Sofia Wentz
• Annika Rose Werlinger, RBT

• Neurology Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Neurology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.