Jedediah Larsen Wheeler, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A11998 Issued in CA

Practice address

1820 41St Ave Ste D
Capitola, CA 95010-2516

Phone

(831) 476-3000

Fax

(831) 476-9009

NPI assigned

Jan 4, 2011

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Dignity Health Medical Foundation

  dba Mercy Medical Group, a service of Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment NPD
• Dignity Health Medical Foundation

  dba Dignity Health Medical Group - Dominican, a service of Dignity Health

  • Multi-Specialty Clinic/Center
  • Santa Cruz, CA
  • NPI 1598961245
  NPD
• Dignity Health Medical Foundation

  dba Dignity Health Medical Group - North State, a service of Dignity Healt

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Dignity Health

  dba Dominican Hospital

  • General Acute Care Hospital
  • Santa Cruz, CA
  • NPI 1427181007
  NPD (past)
• Dignity Health Medical Foundation

  dba Dignity Health Medical Group - Dominican, a service of Dignity Health

  • Multi-Specialty Clinic/Center
  • Santa Cruz, CA
  • NPI 1649446352
  NPD (past)
• Dignity Health

  dba St. Rose Dominican Hospital, Siena Campus

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  NPD (past)

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1861796989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN: CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 41ST AVE STE D",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102516",
            "telephone_number": "831-476-3000",
            "fax_number": "831-476-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "JEDEDIAH",
        "middle_name": "LARSEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-04",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A11998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Keisha Wells
• Cassandra Welsh
• West Cliff Physical Therapy Inc (West Cliff Physical Therapy)
• Western Medical Associates
• Western Medical Associates
• Adam Lawrence White, L.AC., DIPL.AC.
• Whole Medicine LLC
• Deshanique Williams
• Patrick Williams, P.T.
• Savannah Williams

• Pediatrics Physician in Capitola, CA
• Providers in Capitola, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.