Individual provider Active NPI

Doris Wenger, CRNP

  • Pediatric Nurse Practitioner
  • Coatesville, PA
National Provider Identifier
1518172899
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
VP001911D Issued in PA
Practice address
495 Highlands Blvd
Suite 100
Coatesville, PA 19320
Phone
(610) 384-9500
Fax
(610) 384-3998
NPI assigned
May 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Pediatric Nurse Practitioner 363LP0200X VP001911D PA Primary

Addresses

Primary practice location

495 Highlands Blvd
Suite 100
Coatesville, PA 19320

Mailing address

495 Highlands Blvd
Suite 100
Coatesville, PA 19320
Phone (610) 384-9500

Other identifiers 3

IdentifierTypeStateIssuer
VP001911DOtherPACRNP LICENSE
RN193094LOtherPARN LICENSE
005397OtherPAPRESCRIPTION AUTH

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

LicenseStateTypeSpecialty
VP001911DPAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518172899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 HIGHLANDS BLVD",
            "address_2": "SUITE 100",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "19320",
            "telephone_number": "610-384-9500",
            "fax_number": "610-384-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 HIGHLANDS BLVD",
            "address_2": "SUITE 100",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "19320",
            "telephone_number": "610-384-9500",
            "fax_number": "610-384-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "DORIS",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "VP001911D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP LICENSE",
            "identifier": "VP001911D",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN193094L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIPTION AUTH",
            "identifier": "005397",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coatesville, PA

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.