Individual provider Active NPI

Martin W Wetzel, MD

  • Psychiatry Physician
  • Omaha, NE
National Provider Identifier
1487679437
Registry record updated Aug 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
18316 Issued in NE
Practice address
9726 Fieldcrest Dr
Omaha, NE 68114-4933
Phone
(402) 980-6431
Fax
(402) 393-8639
NPI assigned
Jul 12, 2006
Last updated
Aug 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 18316 NE Primary

Addresses

Primary practice location

9726 Fieldcrest Dr
Omaha, NE 68114-4933

Mailing address

9726 Fieldcrest Dr
Omaha, NE 68114-4933
Phone (402) 980-6431

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

LicenseStateTypeSpecialty
18316NEMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344643200000",
    "number": "1487679437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9726 FIELDCREST DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144933",
            "telephone_number": "402-980-6431",
            "fax_number": "402-393-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9726 FIELDCREST DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144933",
            "telephone_number": "402-980-6431",
            "fax_number": "402-393-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "MARTIN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "18316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2012; 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.