Individual provider Active NPI

Wendy Lee Fitzgerald, RN CRNP FAMILY NURSE

  • Nurse Practitioner
  • Ocean City, MD
National Provider Identifier
1477652238
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP104225 Issued in MD
Practice address
12417 Ocean Gateway
Herring Creek Professional Center BLDG a Suite 5
Ocean City, MD 21842
Phone
(410) 213-0111
Fax
(410) 213-8459
NPI assigned
Sep 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R104225 MD
Nurse Practitioner 363L00000X NP104225 MD Primary

Addresses

Primary practice location

12417 Ocean Gateway
Herring Creek Professional Center BLDG a Suite 5
Ocean City, MD 21842

Mailing address

10635 Shady Drive
Berlin, MD 21811
Phone (410) 641-9007

Other identifiers 1

IdentifierTypeStateIssuer
F6200002OtherBCBS

Other names 1

  • Mrs. Wendy Lee Macwha Former name

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)
Not enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
NP104225MDMDNurse Practitioner
R104225MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
William T. Greer III M.D. P.C. Past Accepting new patients
Edmund J. Maclaughlin, MD, LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1183852800000",
    "number": "1477652238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10635 SHADY DRIVE",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-641-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12417 OCEAN GATEWAY",
            "address_2": "HERRING CREEK PROFESSIONAL CENTER BLDG A SUITE 5",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "21842",
            "telephone_number": "410-213-0111",
            "fax_number": "410-213-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "WENDY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RN CRNP FAMILY NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R104225",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "NP104225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "F6200002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "MACWHA",
            "middle_name": "LEE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ocean City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.