Active NPI
Wendi Dolloff, MT
- Specialist
- Gorham, ME
National Provider Identifier
1659566016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MT2491
- Practice address
- 18 Mechanic St
Gorham, ME 04038-1510 - Phone
- (207) 890-5272
- NPI assigned
- Sep 10, 2007
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MT2491 | ME | Primary |
Addresses
Primary practice location
18 Mechanic St
Gorham, ME 04038-1510
Mailing address
24 Bramblewood Lane
Unit B
Gorham, ME 04038
Phone (207) 890-5272
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 099638 | Other | ME | ANTHEM BLUE CROSS BLUE SH |
Other names 1
- Wendi Griswold
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
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT2491 | ME | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438300800000",
"number": "1659566016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 BRAMBLEWOOD LANE",
"address_2": "UNIT B",
"city": "GORHAM",
"state": "ME",
"postal_code": "04038",
"telephone_number": "207-890-5272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 MECHANIC ST",
"city": "GORHAM",
"state": "ME",
"postal_code": "040381510",
"telephone_number": "207-890-5272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLLOFF",
"first_name": "WENDI",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-10",
"last_updated": "2015-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ME",
"license": "MT2491",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "099638",
"state": "ME"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "WENDI",
"last_name": "GRISWOLD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gorham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.