Active NPI
Ellen Beth Wolfson, MD
- Pediatrics Physician
- Wallingsford, CT
National Provider Identifier
1659480309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 027290
- Practice address
- 97 Barnes Rd
Wallingsford, CT 06492 - Phone
- (203) 265-9890
- Fax
- (203) 265-3321
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 027290 | CT | Primary |
Addresses
Primary practice location
97 Barnes Rd
Wallingsford, CT 06492
Mailing address
97 Barnes Rd
Suite 6
Wallingsford, CT 06492
Phone (203) 265-9890
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027290 | CT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Medicine of Wallingford LLP | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Wallingford, CT
- NPI 1619004975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659480309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 BARNES RD",
"address_2": "SUITE 6",
"city": "WALLINGSFORD",
"state": "CT",
"postal_code": "06492",
"telephone_number": "203-265-9890",
"fax_number": "203-265-3321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 BARNES RD",
"city": "WALLINGSFORD",
"state": "CT",
"postal_code": "06492",
"telephone_number": "203-265-9890",
"fax_number": "203-265-3321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFSON",
"first_name": "ELLEN",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "027290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.