Active NPI
Wesley Robert Ortmann
- General Practice Physician
- China Lake, CA
National Provider Identifier
1871241927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 0102208246
- Practice address
- 1 Administration Circle
China Lake, CA 93555 - Phone
- (301) 400-3995
- NPI assigned
- Mar 16, 2022
- Last updated
- Mar 21, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Physician | 208D00000X | 0102208246 | VA | Primary |
Addresses
Primary practice location
1 Administration Circle
China Lake, CA 93555
Mailing address
1 Administration Circle
China Lake, CA 93555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102208246 | VA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710979200000",
"number": "1871241927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ADMINISTRATION CIRCLE",
"city": "CHINA LAKE",
"state": "CA",
"postal_code": "93555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ADMINISTRATION CIRCLE",
"city": "CHINA LAKE",
"state": "CA",
"postal_code": "93555",
"telephone_number": "301-400-3995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTMANN",
"first_name": "WESLEY",
"middle_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-16",
"last_updated": "2024-03-21",
"certification_date": "2024-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0102208246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in China Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.