Guito Wingfield, M.D

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Practice address

1755 Kresky Ave.
Centralia, WA 98531

Phone

(360) 669-0098

Fax

(360) 669-0121

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

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.

• Rejuventa Medical Corp.

  • Primary Care Clinic/Center
  • Centralia, WA
  • NPI 1013550987
  NPD Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1699792242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 KRESKY AVE. BOX #16",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-736-1961",
            "fax_number": "360-736-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 KRESKY AVE.",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-669-0098",
            "fax_number": "360-669-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGFIELD",
        "first_name": "GUITO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "00048810",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013550987",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Bergmann Wilson, DDS
• Paula Wilson
• Rebekah Ruby Lin Wilson
• Robert Wilson, AAC
• Justin Wimpress
• Ayla Marie Withey
• Ashley Dawn Wofford
• Angela Sui Yee Wong
• Edith Wong, DDS
• Edward Ming Wong, PHARM.D.

• Primary Care Clinic/Center in Centralia, WA
• Providers in Centralia, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.