Active NPI
Melissa G. Wuthier, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- Colorado Springs, CO
National Provider Identifier
1396843306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- M 9404
- Practice address
- 3141 Centennial Blvd
Colorado Springs, CO 80907-4094 - Phone
- (719) 327-5660
- Fax
- (719) 227-4660
- NPI assigned
- Sep 21, 2006
- Last updated
- Dec 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | M 9404 | ID | Primary |
Addresses
Primary practice location
3141 Centennial Blvd
Colorado Springs, CO 80907-4094
Mailing address
8110 Routt CT
Colorado Springs, CO 80919-3849
Phone (208) 308-2215
Other practice location 1
260 2nd Ave E
VA Community Based Outpatient Clinic
Twin Falls, ID 83301-6242
Phone (208) 732-0959
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240604004110 | CO | Order and Referring Only - Internal Medicine | 9436343514 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M 9404 | ID | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576800000000",
"number": "1396843306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8110 ROUTT CT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809193849",
"telephone_number": "208-308-2215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3141 CENTENNIAL BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809074094",
"telephone_number": "719-327-5660",
"fax_number": "719-227-4660"
}
],
"practiceLocations": [
{
"address_1": "260 2nd Ave E",
"address_2": "VA Community Based Outpatient Clinic",
"address_purpose": "LOCATION",
"city": "Twin Falls",
"state": "ID",
"postal_code": "833016242",
"country_code": "US",
"telephone_number": "208-732-0959",
"fax_number": "208-422-1405",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WUTHIER",
"first_name": "MELISSA",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2019-12-20",
"certification_date": "2019-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "ID",
"license": "M 9404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.