Active NPI
John Robert Wichert, M.D.
- Obstetrics & Gynecology Physician
- Newport, OR
National Provider Identifier
1982644282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD167094
- Practice address
- 775 SW Ninth Street
Suite H
Newport, OR 97365-4876 - Phone
- (541) 574-4767
- Fax
- (541) 574-4747
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 4301053932 | MI | |
| Obstetrics & Gynecology Physician | 207V00000X | MD167094 | OR | Primary |
Addresses
Primary practice location
775 SW Ninth Street
Suite H
Newport, OR 97365-4876
Mailing address
775 SW Ninth Street
Suite H
Newport, OR 97365-4876
Phone (541) 574-4767
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4679576 | Medicaid | MI | |
| 500679017 | Medicaid | OR | |
| 07-70022 | Other | MI | PHP FAMILYCARE |
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 |
|---|---|---|---|
| MD167094 | OR | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445472000000",
"number": "1982644282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "775 SW NINTH STREET",
"address_2": "SUITE H",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973654876",
"telephone_number": "541-574-4767",
"fax_number": "541-574-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 SW NINTH STREET",
"address_2": "SUITE H",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973654876",
"telephone_number": "541-574-4767",
"fax_number": "541-574-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICHERT",
"first_name": "JOHN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2015-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MI",
"license": "4301053932",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OR",
"license": "MD167094",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4679576",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500679017",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP FAMILYCARE",
"identifier": "07-70022",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.