Active NPI
Patricia A Wunder
- Surgical Technologist
- Meridian, ID
National Provider Identifier
1497818983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 00F570
- Practice address
- 3011 S Tagish Way
Meridian, ID 83642-9157 - Phone
- (208) 283-9398
- Fax
- (208) 288-2535
- NPI assigned
- Dec 18, 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 |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 00F570 | ID | Primary |
Addresses
Primary practice location
3011 S Tagish Way
Meridian, ID 83642-9157
Mailing address
3011 S Tagish Way
Meridian, ID 83642-9157
Phone (208) 283-9398
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00F570 | Other | ID | CERTIFIED FIRST ASSISTANT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00F570 | ID | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497818983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3011 S TAGISH WAY",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836429157",
"telephone_number": "208-283-9398",
"fax_number": "208-288-2535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3011 S TAGISH WAY",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836429157",
"telephone_number": "208-283-9398",
"fax_number": "208-288-2535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUNDER",
"first_name": "PATRICIA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "ID",
"license": "00F570",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED FIRST ASSISTANT",
"identifier": "00F570",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
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.