Kathie R. Wuellner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-059452 Issued in IL

Practice address

4 Memorial Dr.
Ste 110
Alton, IL 62002

Phone

(618) 474-1711

Fax

(618) 474-2793

NPI assigned

Feb 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kathie R Rosentreter Former name

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2511/brand/1/csg/1/fhir/r4
• Direct secure messaging: kathie.wuellner.1@2511.direct.athenahealth.com

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.

• Pediatric Healthcare Unlimited

  • Pediatrics Physician
  • Alton, IL
  • NPI 1982766390
  NPD (past) Authorized official
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • O Fallon, IL
  • NPI 1477076263
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1962537332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR.",
            "address_2": "STE 110",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "62002",
            "telephone_number": "618-474-1711",
            "fax_number": "618-474-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR.",
            "address_2": "STE 110",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "62002",
            "telephone_number": "618-474-1711",
            "fax_number": "618-474-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUELLNER",
        "first_name": "KATHIE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-059452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059452",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHIE",
            "last_name": "ROSENTRETER",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Warren Woolsey, MA
• Johnathan Wright, BS
• Keri Ronice Wright, MSED.,LPC
• William Kevin Wright, O.D.
• John C Wuellner
• Duyen C Xin, OD
• Myles Yanta, MD
• Amy Yates
• Tiffany Yinger, LSW
• Marilyn G Yogore-Thompson

• Pediatrics Physician in Alton, IL
• Providers in Alton, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.