Individual provider Active NPI

Kathy L Wehrle, R.D.

  • Registered Dietitian
  • Fort Wayne, IN
National Provider Identifier
1376859967
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
37000439A Issued in IN
Practice address
11055 Twin Creeks CV
Fort Wayne, IN 46845-2204
Phone
(260) 425-6120
Fax
(260) 425-6115
NPI assigned
Aug 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 37000439A IN Primary

Addresses

Primary practice location

11055 Twin Creeks CV
Fort Wayne, IN 46845-2204

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other identifiers 2

IdentifierTypeStateIssuer
000000675919OtherINANTHEM -NEOB/GYN
000000675940OtherINANTHEM PFC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37000439AINMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Hospital, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1376859967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11055 TWIN CREEKS CV",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468452204",
            "telephone_number": "260-425-6120",
            "fax_number": "260-425-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHRLE",
        "first_name": "KATHY",
        "middle_name": "L",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37000439A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM -NEOB/GYN",
            "identifier": "000000675919",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PFC",
            "identifier": "000000675940",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.