Wanless Ear, Nose & Throat LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

WANLESS EAR, NOSE & THROAT LLC

Practice address

1513 Union Ave Ste 1200
Moberly, MO 65270-9405

Phone

(660) 263-4600

Fax

(660) 263-4640

NPI assigned

Feb 23, 2006

Organization subpart

No

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

Authorized official

Name

Kirk M. Wanless, MDNPI 1497749485

Title

Physician Owner

Phone

(660) 263-4600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kirk M Wanless, MD

  • Otolaryngology Physician
  • Moberly, MO
  • NPI 1497749485
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1083689889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 UNION AVE STE 1200",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709405",
            "telephone_number": "660-263-4600",
            "fax_number": "660-263-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 UNION AVE STE 1200",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709405",
            "telephone_number": "660-263-4600",
            "fax_number": "660-263-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANLESS EAR, NOSE & THROAT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "WANLESS",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "660-263-4600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Vorrath, DDS
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• William George Wall II, CRNA
• Kirk M Wanless, MD
• Rebekah Sue Weidenaar, PLPC
• Diana Wemhoff, APRN, BC
• Misty Joyce Werkmeister, PLPC
• Taylor M Wesley, PHYSICIAN ASSISTANT

• Otolaryngology Physician in Moberly, MO
• Providers in Moberly, MO by specialty
• Otolaryngology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.