Individual provider Active NPI

Gina M Wendricks, AUD

  • Audiologist
  • Owatonna, MN
National Provider Identifier
1639466295
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
626-156 Issued in WI
Practice address
2200 NW 26TH St
Owatonna, MN 55060-5503
Phone
(507) 451-1120
NPI assigned
Jul 5, 2011
Last updated
Aug 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 626-156 WI Primary
Audiologist-Hearing Aid Fitter 237600000X 8813 MN

Addresses

Primary practice location

2200 NW 26TH St
Owatonna, MN 55060-5503

Mailing address

PO Box 1866
Green Bay, WI 54305-1866
Phone (920) 445-7226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160719000689 WI Practitioner - Qualified Audiologist 8123296175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

923 Eliza St
Green Bay, WI 54301-3234
Phone (920) 965-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8813MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Aug 12, 2019 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Aug 12, 2019 Accepting new patients
Bellin Memorial Hospital, Inc CurrentSince Aug 12, 2019 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Aug 12, 2019 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

923 Eliza St
Green Bay, WI 54301
Phone (920) 965-4700

933 Waube Ln
Green Bay, WI 54304
Phone (920) 548-9500

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: gwendricks183662@direct.thedacare.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1639466295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1866",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543051866",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "507-451-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDRICKS",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "626-156",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MN",
            "license": "8813",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.