Phillip Joshua Wenzell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.142824 Issued in OH

Practice address

500 Lincoln Park Blvd Ste 220
Kettering, OH 45429-6404

Phone

(937) 294-4487

NPI assigned

Mar 25, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 19, 2023 through Jan 19, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1679078406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD STE 220",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454296404",
            "telephone_number": "937-294-4487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 W Lexington Ste 100",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452123667",
            "country_code": "US",
            "telephone_number": "513-977-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENZELL",
        "first_name": "PHILLIP",
        "middle_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-25",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.142824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwenzell602993@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "500 Lincoln Park Blvd Ste 220",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "500 Lincoln Park Blvd Ste 220",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Wells, PHARMD
• Michele Wells
• Tiffany Nicole Wells
• Ashley Elizabeth Welsh
• Emily M Wenker, M.ED., BCBA
• Brian Wesche, RN
• Pamela M Wessel, LPCC
• Stephanie Westerbeck, APRN NP-C
• Lauren Wetrich, M.A., CCC-SLP
• Sandra Lynn Wheeler, RN BSN

• Family Medicine Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.