Paul Wertz, RN-BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1616934 Issued in CO

Practice address

233 Main Street, Suite C.
San Luis, CO 81152-8115

Phone

(719) 672-3465

NPI assigned

Dec 18, 2017

Last updated

Jul 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Richard Paul Wertz Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Costilla

  • Public Health or Welfare Agency
  • San Luis, CO
  • NPI 1427722669
  NPD
• County of Costilla

  dba Costilla County Public Health Agency

  • Public Health or Welfare Agency
  • San Luis, CO
  • NPI 1972725455
  NPD
• County of Rio Grande

  • Public Health or Welfare Agency
  • Del Norte, CO
  • NPI 1184773061
  NPD (past)

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1558877290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "SAN LUIS",
            "state": "CO",
            "postal_code": "811520099",
            "telephone_number": "719-672-3465",
            "fax_number": "719-672-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 MAIN STREET, SUITE C.",
            "city": "SAN LUIS",
            "state": "CO",
            "postal_code": "811528115",
            "telephone_number": "719-672-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTZ",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "RN-BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2021-07-26",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1616934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000190429",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHARD",
            "last_name": "WERTZ",
            "middle_name": "PAUL",
            "prefix": "MR.",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• San Luis Valley Community Mental Health Center (San Luis Valley Behavioral Health Group)
• San Luis Valley Community Mental Health Center (San Luis Valley Behavioral Health Group)
• San Luis Valley Community Mental Health Center, Inc. (San Luis Valley Behavioral Health Group)
• Valley-Wide Health Systems, Inc (San Luis Rehabilitation & Physical Therapy)
• Valley-Wide Health Systems, Inc (San Luis Health Center)

• Registered Nurse in San Luis, CO
• Providers in San Luis, CO by specialty
• Registered Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.