Active NPI
Bethany Rose Wolf, NCMA
- Nurse's Aide
- Moline, IL
National Provider Identifier
1750801833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- Practice address
- 4600 3Rd St
Moline, IL 61265-6106 - Phone
- (309) 779-2871
- Fax
- (309) 779-2167
- NPI assigned
- Jun 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | Primary |
Addresses
Primary practice location
4600 3Rd St
Moline, IL 61265-6106
Mailing address
4600 3Rd St
Moline, IL 61265-6106
Other practice location 1
2200 3rd Ave
Rock Island, IL 61201-8840
Phone (309) 779-3080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1750801833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 3RD ST",
"city": "MOLINE",
"state": "IL",
"postal_code": "612656106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 3RD ST",
"city": "MOLINE",
"state": "IL",
"postal_code": "612656106",
"telephone_number": "309-779-2871",
"fax_number": "309-779-2167"
}
],
"practiceLocations": [
{
"address_1": "2200 3rd Ave",
"address_purpose": "LOCATION",
"city": "Rock Island",
"state": "IL",
"postal_code": "612018840",
"country_code": "US",
"telephone_number": "309-779-3080",
"fax_number": "309-779-2819",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLF",
"first_name": "BETHANY",
"middle_name": "ROSE",
"credential": "NCMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-21",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.