Active NPI
Thomas Osborn Wansleben, PA-C
- Physician Assistant
- Lebanon, NH
National Provider Identifier
1063456879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010
- Practice address
- 1 Medical Center Dr
Lebanon, NH 03756-1000 - Phone
- (603) 653-9500
- Fax
- (603) 650-0915
- NPI assigned
- Jun 15, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010 | NH | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Lebanon, NH 03756-1000
Mailing address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 653-9500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40005138 | Medicaid | NH | |
| 0AP0936 | Medicaid | VT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010 | NH | MD | Genetic Counselor (M.S.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1063456879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-653-9500",
"fax_number": "603-650-0915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-653-9500",
"fax_number": "603-650-0915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANSLEBEN",
"first_name": "THOMAS",
"middle_name": "OSBORN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NH",
"license": "0010",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40005138",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0AP0936",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.