Individual provider Active NPI

Wayne Edison Houpt Jr., MD

  • Psychiatry Physician
  • Pomona, CA
National Provider Identifier
1396796058
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A45153 Issued in CA
Practice address
2008 N Garey Ave
Pomona, CA 91767-2722
Phone
(909) 623-6131
Fax
(909) 865-9281
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A45153 CA Primary

Addresses

Primary practice location

2008 N Garey Ave
Pomona, CA 91767-2722

Mailing address

2008 N Garey Ave
Pomona, CA 91767-2722
Phone (909) 623-6131

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Mental Health Center 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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1396796058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672722",
            "telephone_number": "909-623-6131",
            "fax_number": "909-865-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672722",
            "telephone_number": "909-623-6131",
            "fax_number": "909-865-9281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUPT",
        "first_name": "WAYNE",
        "middle_name": "EDISON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A45153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.