James A Wimsatt III, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4900 Issued in OK

Practice address

5955 Zeamer Ave
Elmendorf AFB, AK 99506-3702

Phone

(907) 580-5202

Fax

(907) 580-5022

NPI assigned

Sep 29, 2005

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

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Summit Oral Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Wasilla, AK
  • NPI 1174709927
  Medicare reassignment NPD

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1083601686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13231 FULLENWIDER CIR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995776709",
            "telephone_number": "907-580-5202",
            "fax_number": "907-580-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-5202",
            "fax_number": "907-580-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMSATT",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "4900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Maria Trozzolo, AU.D.
• Shannon J Tyler
• Richard Alan Vanderweele, D.M.D.
• Adriana Vargas-Geminiano
• Daniel White, IDMT
• Matthew J Wolf, MD
• Jesse Phillip Wray

• Oral and Maxillofacial Surgery (Dentist) in Elmendorf AFB, AK
• Providers in Elmendorf AFB, AK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.