Active NPI
Ellen J Westdorp, M.D.
- Emergency Medicine Physician
- Weston, WI
National Provider Identifier
1407898521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 47756
- Practice address
- 3400 Ministry Pkwy
Weston, WI 54476-5220 - Phone
- (715) 393-3000
- NPI assigned
- Jun 12, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 47756 | WI | Primary |
Addresses
Primary practice location
3400 Ministry Pkwy
Weston, WI 54476-5220
Mailing address
PO Box 78758
Milwaukee, WI 53278-0758
Phone (800) 818-6961
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34619600 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47756 | WI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Health Physicians | Emergency Medicine | Past | Accepting new patients |
| Marshfield Clinic Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinic/Center
- Marshfield, WI
- NPI 1952347981
-
- Internal Medicine Physician
- Kansas City, MO
- NPI 1669456257
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1407898521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 78758",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532780758",
"telephone_number": "800-818-6961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 MINISTRY PKWY",
"city": "WESTON",
"state": "WI",
"postal_code": "544765220",
"telephone_number": "715-393-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTDORP",
"first_name": "ELLEN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "47756",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34619600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weston, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.