Active NPI
Wendell Alan Rohrer, PHD, HSPP
- Clinical Neuropsychologist
- Elkhart, IN
National Provider Identifier
1790800910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 20040843
- Practice address
- 600 East Blvd
Elkhart, IN 46514-2483 - Phone
- (574) 523-3242
- Fax
- (574) 523-7917
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 20040843 | IN | Primary |
| Rehabilitation Psychologist | 103TR0400X | 20040843 | IN |
Addresses
Primary practice location
600 East Blvd
Elkhart, IN 46514-2483
Mailing address
PO Box 4667
South Bend, IN 46634-4667
Phone (574) 523-3148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20040843 | Other | IN | STATE LICENSE |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20040843 | IN | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239235200000",
"number": "1790800910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4667",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466344667",
"telephone_number": "574-523-3148",
"fax_number": "574-523-3492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 EAST BLVD",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142483",
"telephone_number": "574-523-3242",
"fax_number": "574-523-7917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROHRER",
"first_name": "WENDELL",
"middle_name": "ALAN",
"credential": "PHD, HSPP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2009-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "IN",
"license": "20040843",
"primary": true
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "IN",
"license": "20040843",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "20040843",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.