Wansom Medical Center, P.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301038906 Issued in MI

Legal business name

WANSOM MEDICAL CENTER, P.C.

Practice address

1492 N Monroe St
Monroe, MI 48162-4210

Phone

(734) 242-3060

Fax

(734) 242-3062

NPI assigned

Jul 22, 2008

Last updated

Jul 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chate Wansom, M.D.NPI 1780785931

Title

President

Phone

(734) 242-3060

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chate Wansom, M.D.

  • General Practice Physician
  • Monroe, MI
  • NPI 1780785931
  Authorized official Same address or phone

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1902061799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624210",
            "telephone_number": "734-242-3060",
            "fax_number": "734-242-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624210",
            "telephone_number": "734-242-3060",
            "fax_number": "734-242-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANSOM MEDICAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "WANSOM",
        "authorized_official_first_name": "CHATE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-242-3060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301038906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0580012",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1395936",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter J. Searcey Center, Inc.
• James Tyreill Walters, DO
• Jacob Waltz
• James Waltz, LBSW
• Sharon Joy Wampler, MA LPC
• Chate Wansom, M.D.
• Karen M Warren, NURSE PRACTITIONER
• Hannah Watkins
• Kristy Lynne Watson, O.D.
• Abigail Waynick

• General Practice Physician in Monroe, MI
• Providers in Monroe, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.