Individual provider Active NPI

Wendy Mieko Murakami, APRN

  • Gerontology Nurse Practitioner
  • Manchester, CT
National Provider Identifier
1508024894
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
001156 Issued in CT
Practice address
375 E Center St
Manchester, CT 06040-4445
Phone
(860) 646-0166
Fax
(860) 645-7534
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 001156 CT Primary
Registered Nurse 163W00000X R50878 CT
Nurse Practitioner 363L00000X 184911 MA
Nurse Practitioner 363L00000X 1156 CT

Addresses

Primary practice location

375 E Center St
Manchester, CT 06040-4445

Mailing address

49 Hartford Tpke
Vernon, CT 06066-5242
Phone (860) 646-0166

Other identifiers 2

IdentifierTypeStateIssuer
S47357OtherUPIN
00413802MedicaidCT

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
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1156CTMDAddiction (Substance Use Disorder) Counselor
R50878CTMDRegistered Nurse
184911MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MW Wellness VIII, LLC PastSince Jul 24, 2022 Accepting new patients
MW Wellness II, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1508024894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665242",
            "telephone_number": "860-646-0166",
            "fax_number": "860-645-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404445",
            "telephone_number": "860-646-0166",
            "fax_number": "860-645-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURAKAMI",
        "first_name": "WENDY",
        "middle_name": "MIEKO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "001156",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "R50878",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "184911",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "1156",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "S47357",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00413802",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.