Joseph Edward Wren, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00045730 Issued in WA

Practice address

55 W Tietan St
Walla Walla, WA 99362-4445

Phone

(509) 525-3720

Fax

(509) 522-1593

NPI assigned

Dec 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joseph.wren.1@28594.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/28594/brand/1/csg/1/fhir/r4

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.

• Privia Medical Group Washington, PLLC

  • Clinic/Center
  • Walla Walla, WA
  • NPI 1780658419
  Medicare reassignment NPD
• Walla Walla Clinic, Inc.

  • Ambulatory Surgical Clinic/Center
  • Walla Walla, WA
  • NPI 1760568273
  NPD
• Walla Walla Clinic, Inc.

  • Clinic/Center
  • Milton Freewater, OR
  • NPI 1063521862
  NPD
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  NPD (past)
• Wwu Campus Health & Wellness

  • Student Health Clinic/Center
  • College Place, WA
  • NPI 1629048848
  NPD (past)

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

{
    "created_epoch": "1134172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699750869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624445",
            "telephone_number": "509-525-3720",
            "fax_number": "509-522-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624445",
            "telephone_number": "509-525-3720",
            "fax_number": "509-522-1593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 S 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993624118",
            "country_code": "US",
            "telephone_number": "509-527-8152",
            "fax_number": "509-527-8010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WREN",
        "first_name": "JOSEPH",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00045730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016587",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carole Goles Wong, PT
• Suwong Wongsuwan, MD
• Ryan Ladell Wood, D.D.S.
• Brenda Worden, PTA
• Richard A Worthington
• Aubree Faye Wright
• Kathryn J Wright, PTA
• Shuangben Wu, LMT
• Jared L Wutzke, M.D.
• WWC Physicians PC

• Pediatrics Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.