Individual provider Active NPI

Melissa G. Wuthier, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Colorado Springs, CO
National Provider Identifier
1396843306
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
M 9404 Issued in ID
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, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240604004110 CO Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9436343514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M 9404IDMDGeriatric 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

Verify at the official NPI Registry.