Organization Active NPI

Wellington Provider Group PC

  • General Practice Physician
  • Seattle, WA
National Provider Identifier
1336859826
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WELLINGTON PROVIDER GROUP PC
Practice address
1455 NW Leary Way Ste 400
Seattle, WA 98107-5138
Phone
(859) 439-0400
NPI assigned
Nov 25, 2022
Organization subpart
Yes
Parent organization
WELLINGTON PROVIDER GROUP PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2022

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

Authorized official

Name
Brittany Dennis
Title
Credentialing Manger
Phone
(859) 518-8817

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1455 NW Leary Way Ste 400
Seattle, WA 98107-5138

Mailing address

535 Wellington Way Ste 330
Lexington, KY 40503-1331

National Provider Directory

National Provider Directory
Part of
Wellington Provider Group P

NPI Registry JSON

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

{
    "created_epoch": "1669334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669334400000",
    "number": "1336859826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 WELLINGTON WAY STE 330",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 NW LEARY WAY STE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075138",
            "telephone_number": "859-439-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLINGTON PROVIDER GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLINGTON PROVIDER GROUP PC",
        "enumeration_date": "2022-11-25",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "CREDENTIALING MANGER",
        "authorized_official_telephone_number": "859-518-8817"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; 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.