Sandra Wollenberg, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R53467 Issued in NM

Practice address

753 N Main St
Suite a
Cottonwood, AZ 86326-3649

Phone

(928) 634-7470

Fax

(928) 639-3280

NPI assigned

Dec 29, 2005

Sex

Female

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)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/57966
• FHIR API: https://fhir4.healow.com/fhir/r4/CHCFAD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Medical Center

  • Rural Health Clinic/Center
  • Fernley, NV
  • NPI 1508003112
  NPD (past)

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1811974892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "address_2": "SUITE A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263649",
            "telephone_number": "928-634-7470",
            "fax_number": "928-639-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "address_2": "SUITE A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263649",
            "telephone_number": "928-634-7470",
            "fax_number": "928-639-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLENBERG",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R53467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justine Winchester, NP
• Mary Winds, LISAC
• Windsor Austin House, LLC (Austin House Assisted Living)
• Windsor Austin House, LLC (Austin House Assisted Living)
• Charles T Wisneski, MSWLCSW
• Sheryl Anne Wolowice, MPT
• Woodford Orthodontics
• Barbara S. Woodlief, PTA
• Tamira Dee Woodward, R.N.
• Jeremy Woods Wray, D.O.

• Family Nurse Practitioner in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.