Mary B. Wonderly, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35-082561 Issued in OH

Practice address

1479 N River Rd
Fremont, OH 43420-9760

Phone

(419) 355-9440

Fax

(419) 355-9443

NPI assigned

Jan 16, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891774030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448710378",
            "telephone_number": "419-609-1112",
            "fax_number": "419-609-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 N RIVER RD",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434209760",
            "telephone_number": "419-355-9440",
            "fax_number": "419-355-9443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2575 Hayes Ave",
            "address_2": "Suite 5",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "OH",
            "postal_code": "434205201",
            "country_code": "US",
            "telephone_number": "419-332-3560",
            "fax_number": "419-332-3565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONDERLY",
        "first_name": "MARY",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-082561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2396303",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Witmer
• Melissa Wodrich
• Luann R Wolf, CNP
• Women Caring for Women LLC
• Women'S Medical Center, Inc.
• Woodville Professional Healthcare LLC
• Yanke Bionics Inc
• Kimberly R Young, LMT
• Marissa Yzaugirre
• Beverly Ann Zywiczynsi, LPTA

• Family Medicine Physician in Fremont, OH
• Providers in Fremont, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.