Active NPI
Madisen Marie Wolleck
- Rehabilitation Practitioner
- Grass Valley, CA
National Provider Identifier
1619633542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 500 Crown Point Cir
Grass Valley, CA 95945-9561 - Phone
- (530) 265-5811
- NPI assigned
- Nov 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | CA | Primary |
Addresses
Primary practice location
500 Crown Point Cir
Grass Valley, CA 95945-9561
Mailing address
13441 Wolf Rd
Grass Valley, CA 95949-8127
Phone (503) 477-0784
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744848000000",
"number": "1619633542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13441 WOLF RD",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959498127",
"telephone_number": "503-477-0784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CROWN POINT CIR",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959459561",
"telephone_number": "530-265-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLLECK",
"first_name": "MADISEN",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-15",
"last_updated": "2025-04-17",
"certification_date": "2025-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.