Mack Kenneth Wingreen

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A4884 Issued in MD

Practice address

7407 Willow Rd
Frederick, MD 21702-2500

Phone

(301) 644-5600

NPI assigned

May 7, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1770167546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6617 HIGH BEACH CT E",
            "city": "NEW MARKET",
            "state": "MD",
            "postal_code": "217746852",
            "telephone_number": "410-530-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7407 WILLOW RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022500",
            "telephone_number": "301-644-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGREEN",
        "first_name": "MACK",
        "middle_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Winebrenner
• Suzan Anne Winebrenner, PT
• Andrew Wingerd
• Max Eugene Wingerd, M.D.
• Scott Thomas Winget, PSY. D.
• Claire Kirby Winik
• Gerald Roland Winnan, M.D.
• Josianna Marie Winnings
• Constance Winstead
• Michael D. Winton, M.D.

• Physical Therapy Assistant in Frederick, MD
• Providers in Frederick, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.