Individual provider Active NPI

Peter Wechgelaer, MD MPH

  • Aerospace Medicine Physician
  • Jacksonville, NC
National Provider Identifier
1487626800
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Aerospace Medicine PhysicianTaxonomy code 2083A0100X
License
0101054690 Issued in VA
Practice address
Medical Clinic McAs New River
PSC Box 21034
Jacksonville, NC 28545-1034
Phone
(910) 449-6500
Fax
(910) 449-6532
NPI assigned
Feb 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X 0101054690 VA Primary

Addresses

Primary practice location

Medical Clinic McAs New River
PSC Box 21034
Jacksonville, NC 28545-1034

Mailing address

102 Oak Ridge Dr
Havelock, NC 28532-9624
Phone (252) 447-1691

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101054690VAMDAerospace Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487626800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 OAK RIDGE DR",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "285329624",
            "telephone_number": "252-447-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CLINIC MCAS NEW RIVER",
            "address_2": "PSC BOX 21034",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285451034",
            "telephone_number": "910-449-6500",
            "fax_number": "910-449-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WECHGELAER",
        "first_name": "PETER",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "VA",
            "license": "0101054690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

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.