Organization Active NPI

Wybenga Family Healthcare, Inc.

  • Family Medicine Physician
  • Prattville, AL
National Provider Identifier
1710998505
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WYBENGA FAMILY HEALTHCARE, INC.
Practice address
564 N Memorial Dr
Prattville, AL 36067-2132
Phone
(334) 358-2010
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Authorized official

Name
Dr. Maarten A Wybenga, M.D.
Title
Owner
Phone
(334) 358-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

564 N Memorial Dr
Prattville, AL 36067-2132

Mailing address

2257 Taylor Rd
200
Montgomery, AL 36117-7790
Phone (334) 270-9914

National Provider Directory

National Provider Directory

Locations

564 N Memorial Dr
Prattville, AL 36067
Phone (334) 358-2010

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1710998505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 TAYLOR RD",
            "address_2": "200",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177790",
            "telephone_number": "334-270-9914",
            "fax_number": "334-270-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 N MEMORIAL DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360672132",
            "telephone_number": "334-358-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYBENGA FAMILY HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "WYBENGA",
        "authorized_official_first_name": "MAARTEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-358-2010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.