Active NPI
Sydney Melvin Wedmore, MD
- Internal Medicine Physician
- Rockport, MA
National Provider Identifier
1629060934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 36730
- Practice address
- 37G Whistlestop Mall
Rockport, MA 01966-1437 - Phone
- (978) 546-2535
- Fax
- (978) 546-8053
- NPI assigned
- Aug 22, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 36730 | MA | Primary |
Addresses
Primary practice location
37G Whistlestop Mall
Rockport, MA 01966-1437
Mailing address
155 South St
Rockport, MA 01966-2350
Phone (978) 645-3754
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D08051 | Other | MA | BLUE CROSS |
| 714375 | Other | MA | TUFTS |
| 3134628 | Medicaid | MA |
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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258329600000",
"number": "1629060934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 SOUTH ST",
"city": "ROCKPORT",
"state": "MA",
"postal_code": "019662350",
"telephone_number": "978-645-3754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37G WHISTLESTOP MALL",
"city": "ROCKPORT",
"state": "MA",
"postal_code": "019661437",
"telephone_number": "978-546-2535",
"fax_number": "978-546-8053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDMORE",
"first_name": "SYDNEY",
"middle_name": "MELVIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2009-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "36730",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "D08051",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "714375",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3134628",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockport, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.