Individual provider Active NPI

William Terry Wendt

  • Marriage & Family Therapist
  • Niceville, FL
National Provider Identifier
1790316156
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
4400 E Highway 20 Ste 306
Niceville, FL 32578-7703
Phone
(850) 842-2424
NPI assigned
Feb 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

4400 E Highway 20 Ste 306
Niceville, FL 32578-7703

Mailing address

188 Brewer Cir
Mary Esther, FL 32569-2003
Phone (850) 426-1037

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@kruegerwellness.com

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": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1790316156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 BREWER CIR",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325692003",
            "telephone_number": "850-426-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 306",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787703",
            "telephone_number": "850-842-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT",
        "first_name": "WILLIAM",
        "middle_name": "TERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@kruegerwellness.com",
            "affiliation": "N",
            "address_1": "4400 E Highway 20 Ste 306",
            "city": "Niceville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325787703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.