MR. IAN WETHERALL PA-C NPI 1164730289

NPI Information

NPI: 1164730289
Provider Name: MR. IAN WETHERALL, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
455 PINELLAS ST
SUITE 320
CLEARWATER, FL
ZIP 33756
Phone: (727) 446-2273
Get Directions

MR. Ian Wetherall, PA-C is a surgical physician assistant in Clearwater, FL with 14 years of experience. MR. Ian Wetherall, PA-C NPI is 1164730289. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

455 PINELLAS ST
SUITE 320
CLEARWATER, FL
ZIP 33756-354
Phone: (727) 446-2273
Fax: (727) 441-4966

The NPI 1164730289 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/23/2010 and was last updated on 4/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	PA9108763	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	015310600	MEDICAID	FLORIDA
2	Y0S8R	OTHER	FLORIDA	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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