Richard Donald Wetmore, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0059816 Issued in FL

Practice address

4203 Belfort Road
Suite 315
Jacksonville, FL 32216-1418

Phone

(904) 564-4369

Fax

(904) 564-4376

NPI assigned

Dec 27, 2006

Sex

Male

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 4

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.

• First Coast Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1528197993
  NPD (past)
• St. Johns Bluff Family Practice

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1760695852
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1982769295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 BELFORT ROAD",
            "address_2": "SUITE 315",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161418",
            "telephone_number": "904-564-4369",
            "fax_number": "904-564-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 BELFORT ROAD",
            "address_2": "SUITE 315",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161418",
            "telephone_number": "904-564-4369",
            "fax_number": "904-564-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETMORE",
        "first_name": "RICHARD",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0059816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "ME0059816",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "101385",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "12396",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4198569",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Westra, D.M.D.
• Westside Surgery Center LLC (Parkside Surgery Center)
• Westwood Manor Residential Care Home LLC
• Mary Westwood
• Malisa Marie Wetmore, PA-C
• Nancy Jane Wetterer, LMT, NCBTMB, CAP
• William M Wettstein, P.A.
• Amanda Wetzel, APRN
• Edward James Wetzork, D.C.
• Lauren Wexler

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.