John Charles Wallendjack, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MDO19773E Issued in PA

Practice address

3721 Tecport Drive
Health America
Harrisburg, PA 17106-7103

Phone

(717) 540-6774

Fax

(717) 671-2459

NPI assigned

Sep 29, 2006

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780776377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 HILLYMEDE CIRCLE",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171114911",
            "telephone_number": "717-566-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 TECPORT DRIVE",
            "address_2": "HEALTH AMERICA",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171067103",
            "telephone_number": "717-540-6774",
            "fax_number": "717-671-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENDJACK",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MDO19773E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Walker
• Barbara Susan Wall, LMT
• Briana Wallace
• Mark Thomas Wallace
• Kelsey Janelle Wallen, DPT
• Jennifer Hopkins Walsh, P.T.
• Lindsey G Walter, BCBA/LBS
• Ashley Walters
• Gary Donald Walters II, ARRT (R)(T)
• Jamie L. Walters, P.A.

• Internal Medicine Physician in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.