Wellspring Physician, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLSPRING PHYSICIAN, P.C.

Practice address

100 Charles Ewing Blvd Ste 160
Ewing, NJ 08628-3456

Phone

(855) 673-2876

NPI assigned

Feb 13, 2017

Last updated

Jul 28, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victor K Wong

Title

SVP - Operations

Phone

(855) 673-2876

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1366981201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4359 ROANS CHAPEL RD",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHARLES EWING BLVD STE 160",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086283456",
            "telephone_number": "855-673-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING PHYSICIAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SVP - OPERATIONS",
        "authorized_official_telephone_number": "855-673-2876"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.