Active NPI
Susan Wollersheim, MD
- Pediatrics Physician
- Washington, DC
National Provider Identifier
1881897510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A98028
- Practice address
- 3800 Reservoir Rd NW
Georgetown University Hospital, Peds Id, 2-PHC
Washington, DC 20007-2113 - Phone
- (202) 444-8262
- Fax
- (202) 444-7161
- NPI assigned
- Jun 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A98028 | CA | Primary |
Addresses
Primary practice location
3800 Reservoir Rd NW
Georgetown University Hospital, Peds Id, 2-PHC
Washington, DC 20007-2113
Mailing address
3800 Reservoir Rd NW
Georgetown University Hospital, Peds Id, 2-PHC
Washington, DC 20007-2113
Phone (202) 444-8262
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A98028 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310688000000",
"number": "1881897510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 RESERVOIR RD NW",
"address_2": "GEORGETOWN UNIVERSITY HOSPITAL, PEDS ID, 2-PHC",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200072113",
"telephone_number": "202-444-8262",
"fax_number": "202-444-7161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 RESERVOIR RD NW",
"address_2": "GEORGETOWN UNIVERSITY HOSPITAL, PEDS ID, 2-PHC",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200072113",
"telephone_number": "202-444-8262",
"fax_number": "202-444-7161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLLERSHEIM",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2011-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A98028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.