Organization Active NPI

Jeffrey S. Wunning, DPM, LLC

  • Foot & Ankle Surgery Podiatrist
  • Wooster, OH
National Provider Identifier
1396140414
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
003661 Issued in OH
Legal business name
JEFFREY S. WUNNING, DPM, LLC
Practice address
365 Riffel Rd
Wooster, OH 44691-8592
Phone
(330) 345-5500
Fax
(330) 345-7793
NPI assigned
Oct 31, 2014
Last updated
Jan 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Christina Mathis
Title
Practice Manager
Phone
(330) 345-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 003661 OH Primary

Addresses

Primary practice location

365 Riffel Rd
Wooster, OH 44691-8592

Mailing address

365 Riffel Rd Ste a
Wooster, OH 44691-8592
Phone (303) 345-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150610001683 OH DME Supplier - Physician - Podiatry 8224359674 Practice locations: Wooster, OH
O20190415001447 OH Part B Supplier - Clinic/Group Practice 8224359674 Receives reassigned benefits from 4 practitioners
Practice locations: Wooster, OH

National Provider Directory

National Provider Directory
Tax ID family
Jeffrey S Wunning DPM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

68 Park Ave W
Mansfield, OH 44902

365 Riffel Rd
Wooster, OH 44691
Phone (330) 345-5500

365 Riffel Rd
Ste A
Wooster, OH 44691
Phone (330) 345-5500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1396140414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 RIFFEL RD STE A",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918592",
            "telephone_number": "303-345-5500",
            "fax_number": "330-345-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 RIFFEL RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918592",
            "telephone_number": "330-345-5500",
            "fax_number": "330-345-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY S. WUNNING, DPM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "330-345-5500"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "003661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.