Individual provider Active NPI

Sheila L. Wettlaufer, CSFNP

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1679513493
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NP135211 Issued in OR
Practice address
4285 Commercial St SE
Suite 120
Salem, OR 97302-4371
Phone
(503) 585-6455
Fax
(503) 391-0471
NPI assigned
Jun 8, 2006
Last updated
Feb 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NP135211 OR Primary

Addresses

Primary practice location

4285 Commercial St SE
Suite 120
Salem, OR 97302-4371

Mailing address

4285 Commercial St SE
Suite 120
Salem, OR 97302-4371
Phone (503) 585-6455

Other names 1

  • Sheila L. Gardner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080821000265 OR Practitioner - Nurse Practitioner 7517032824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4285 Commercial St SE
Suite 120
Salem, OR 97302-4372
Phone (503) 585-6455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP135211ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Creek Family Clinic Inc Family Medicine CurrentSince May 23, 2012 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Pacific Family Medical Center LLC Family Medicine Past Accepting new patients

Locations

4285 Commercial St SE
Ste 120
Salem, OR 97302
Phone (503) 399-7474

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: sheila.wettlaufer.mcfc@direct.wvp.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1679513493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4285 COMMERCIAL ST SE",
            "address_2": "SUITE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024371",
            "telephone_number": "503-585-6455",
            "fax_number": "503-391-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 COMMERCIAL ST SE",
            "address_2": "SUITE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024371",
            "telephone_number": "503-585-6455",
            "fax_number": "503-391-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTLAUFER",
        "first_name": "SHEILA",
        "middle_name": "L.",
        "credential": "CSFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "NP135211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEILA",
            "last_name": "GARDNER",
            "middle_name": "L.",
            "credential": "CSFNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.