Individual provider Active NPI

Lauren Jacklyn Wolf, MD

  • Pediatrics Physician
  • Bethesda, MD
National Provider Identifier
1366502759
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101237935 Issued in VA
Practice address
8901 Wisconsin Ave
Bethesda, MD 20889-5000
Phone
(301) 295-4000
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101237935 VA Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Bethesda, MD 20889-5000

Mailing address

7700 Arlington Blvd
Falls Church, VA 22042-2929
Phone (703) 681-7176

Other practice location 1

2050A Second St
377 MDG/Scop
Kirtland AFB, NM 87117-5000
Phone (505) 846-3702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20200903003721 VA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3870775406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101237935VAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1366502759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 ARLINGTON BLVD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220422929",
            "telephone_number": "703-681-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895000",
            "telephone_number": "301-295-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050A Second St",
            "address_2": "377 MDG/SCOP",
            "address_purpose": "LOCATION",
            "city": "Kirtland AFB",
            "state": "NM",
            "postal_code": "871175000",
            "country_code": "US",
            "telephone_number": "505-846-3702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "LAUREN",
        "middle_name": "JACKLYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101237935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.