KEVIN RICHARD WANDLER MD
NPI 1205956265
Psychiatry & Neurology - Addiction Medicine in Roswell, GA

Q: What is Kevin Wandler's NPI number?

The NPI number for Kevin Wandler is 1205956265. It was assigned to this individual provider in the NPPES registry on March 30, 2007.

Q: What is Kevin Wandler's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Medicine, with taxonomy code 2084A0401X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Wandler was last updated on January 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 30, 2007

11725 POINTE PL, ROSWELL, GA 30076(470) 990-9483(877) 800-5436 Get Directions Write a Review

NPPES record last updated: January 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 8, 2025, Apr 3, 2024, Jul 30, 2020 (3 updates tracked since 2020).

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About Kevin Richard Wandler Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN RICHARD WANDLER MD (NPI 1205956265) is an individual addiction medicine provider in Roswell, Georgia, licensed in Georgia (92660) and active in the NPI registry since March 2007. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1205956265

Entity TypeIndividualMale

Primary Taxonomy2084A0401X

Provider Legal NameKEVIN RICHARD WANDLERCredential: MD

Location Address11725 POINTE PLRoswell, GA 30076-4636

Mailing Address888 S Hillhurst RdRidgefield, WA 98642-9063 · (754) 300-3120 · Fax (954) 306-8977

Phone(470) 990-9483

Fax(877) 800-5436

Sole ProprietorYes

Enumeration DateMarch 30, 2007

Last NPPES UpdateJanuary 8, 20253 updates tracked since enumeration

NPPES CertifiedJanuary 8, 2025

✔ NPI 1205956265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2084A0401X

Licenses✔ Licensed in GA · 92660✔ Licensed in CO · DR.0055465✔ Licensed in OH · 130525✔ Licensed in MO · 2022048625✔ Licensed in WA · MD60562814✔ Licensed in IN · 01092373A✔ Licensed in NJ · 25MA10809300

Definition

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

Also ListedPreventive Medicine · Addiction MedicineTaxonomy 2083A0300X · License 25MA10809300 (NJ)

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 14421 (AZ), ME110716 (FL)

11725 POINTE PL, Roswell, GA 30076

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Secondary Practice Locations 2

Location 18150 Brookville RdIndianapolis, IN 46239-8903 · Phone (317) 754-7784

Location 2888 S Hillhurst RdRidgefield, WA 98642-9063 · Phone (754) 300-3120 ext. 4118 · Fax (954) 306-8977

Other Identifiers 1

Medicaid004007100FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas City, BridgeSpan Health Company, Kaiser Permanente and more.Insurance ›

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AEGIS GROUP PRACTICE LLC

Occupational Therapist