Individual provider Active NPI

Cheryl Wendt, CPNP

  • Pediatric Nurse Practitioner
  • Wauwatosa, WI
National Provider Identifier
1770623589
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
589-033 Issued in WI
Practice address
3040 N 117TH St Ste 100
Wauwatosa, WI 53222-4128
Phone
(414) 479-9990
Fax
(414) 479-0230
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 589-033 WI Primary

Addresses

Primary practice location

3040 N 117TH St Ste 100
Wauwatosa, WI 53222-4128

Mailing address

5515 W Melvina St
Milwaukee, WI 53216-2220
Phone (414) 871-2590

Other identifiers 1

IdentifierTypeStateIssuer
1770623589MedicaidWI

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)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
589-033WIMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: cwendt8795@direct.chw.org

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1770623589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 W MELVINA ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162220",
            "telephone_number": "414-871-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N 117TH ST STE 100",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224128",
            "telephone_number": "414-479-9990",
            "fax_number": "414-479-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT",
        "first_name": "CHERYL",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "589-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770623589",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.