Individual provider Active NPI

John L Wetzel Jr., APRN

  • Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1568545135
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11023036 Issued in FL
Practice address
348 Bunker Hill Dr
Pensacola, FL 32506-5630
Phone
(251) 455-7858
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1513 AL
Registered Nurse 163W00000X RN9533439 FL
Critical Care Medicine Nurse Practitioner 363LC0200X APRN11023036 FL
Nurse Practitioner 363L00000X APRN11023036 FL Primary

Addresses

Primary practice location

348 Bunker Hill Dr
Pensacola, FL 32506-5630

Mailing address

348 Bunker Hill Dr
Pensacola, FL 32506-5630
Phone (251) 455-7858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230203001813 FL Practitioner - Nurse Practitioner 9830107911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1513ALMDPsychologist
RN9533439FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Management Specialists, LLC Nurse Practitioner CurrentSince Oct 1, 2023 Accepting new patients
Eastern Shore Chiropractic LLC Chiropractor PastSince Mar 1, 2007 Accepting new patients

Locations

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1568545135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 BUNKER HILL DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325065630",
            "telephone_number": "251-455-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 BUNKER HILL DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325065630",
            "telephone_number": "251-455-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1513",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9533439",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "FL",
            "license": "APRN11023036",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11023036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.