Active NPI
Carole B. Wetherhold, CRNA
- Certified Registered Nurse Anesthetist
- Allentown, PA
National Provider Identifier
1871580985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 019438
- Practice address
- 17TH & Chew Street
Allentown, PA 18102 - Phone
- (610) 402-9099
- Fax
- (610) 402-9029
- NPI assigned
- Oct 4, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN167771L | PA | |
| Certified Registered Nurse Anesthetist | 367500000X | 019438 | PA | Primary |
Addresses
Primary practice location
17TH & Chew Street
Allentown, PA 18102
Mailing address
1245 S Cedar Crest Blvd
Suite #301
Allentown, PA 18103-6258
Phone (610) 402-9099
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0011679400004 | Medicaid | PA | |
| 0994143 | Other | PA | KHP CENTRAL |
| 1567631 | Other | PA | HIGHMARK |
| 1567631 | Other | PA | FIRST PRIORITY |
| 2248292000 | Other | PA | INDEP. BLUE CROSS |
| 50026716 | Other | PA | CAPITAL ADVANTAGE |
| 82872 | Other | PA | GEISINGER |
| 7418819 | Other | PA | AETNA |
| 1579546 | Other | PA | GATEWAY |
| CAQH | Other | PA | 11267076 |
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019438 | PA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeastern Anesthesia Physicians P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Allentown, PA
- NPI 1275594830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364515200000",
"number": "1871580985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1245 S CEDAR CREST BLVD",
"address_2": "SUITE #301",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181036258",
"telephone_number": "610-402-9099",
"fax_number": "610-402-9029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17TH & CHEW STREET",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "18102",
"telephone_number": "610-402-9099",
"fax_number": "610-402-9029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETHERHOLD",
"first_name": "CAROLE",
"middle_name": "B.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-04",
"last_updated": "2013-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN167771L",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "019438",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0011679400004",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KHP CENTRAL",
"identifier": "0994143",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "1567631",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY",
"identifier": "1567631",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEP. BLUE CROSS",
"identifier": "2248292000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL ADVANTAGE",
"identifier": "50026716",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER",
"identifier": "82872",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7418819",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1579546",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "11267076",
"identifier": "CAQH",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.