Individual provider Active NPI

Mary Margaret Wollmering, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Branson, MO
National Provider Identifier
1063474484
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
2005031309 Issued in MO
Practice address
545 Branson Landing Blvd.
Ste. #306
Branson, MO 65616
Phone
(417) 336-9728
Fax
(417) 337-9710
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2005031309 MO Primary

Addresses

Primary practice location

545 Branson Landing Blvd.
Ste. #306
Branson, MO 65616

Mailing address

PO Box 770
Branson, MO 65615-0770
Phone (417) 336-9728

Other identifiers 3

IdentifierTypeStateIssuer
206576OtherBCBS
250766OtherHEALTHLINK
P00266172OtherRAILROAD MEDICARE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1063474484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656150770",
            "telephone_number": "417-336-9728",
            "fax_number": "417-337-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BRANSON LANDING BLVD.",
            "address_2": "STE. #306",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-336-9728",
            "fax_number": "417-337-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLMERING",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "2005031309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "206576",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "250766",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00266172",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.