Thomas J. Wachendorf, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0067899 Issued in FL

Practice address

2804 W Marc Knighton CT Ste a
Lecanto, FL 34461-6301

Phone

(352) 746-8000

Fax

(813) 631-3917

NPI assigned

Sep 1, 2006

Last updated

Apr 23, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1346342391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 W MARC KNIGHTON CT STE A",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344616301",
            "telephone_number": "352-746-8000",
            "fax_number": "813-631-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 W MARC KNIGHTON CT STE A",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344616301",
            "telephone_number": "352-746-8000",
            "fax_number": "813-631-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHENDORF",
        "first_name": "THOMAS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2024-04-23",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0067899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walton L Vanhoose, DMD
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• Vladimir J Vlcko, DO
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• Brooke Walker, SLP
• Elizabeth K Warren, BCBA
• James Warren Washburn, D.O.

• Internal Medicine Physician in Lecanto, FL
• Providers in Lecanto, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.