NPIMap

Organization Active NPI

Western OB/GYN LTD

  • Obstetrics & Gynecology Physician
  • Waconia, MN
National Provider Identifier
1093703316
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WESTERN OB/GYN LTD
Practice address
560 S Maple St
Suite 130
Waconia, MN 55387-1733
Phone
(952) 442-2137
Fax
(952) 442-5960
NPI assigned
Oct 11, 2005
Last updated
Jul 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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

Authorized official

Name
Mr. Anthony J Werner, M.B.A.
Title
Chief Operating Officer
Phone
(952) 442-2137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

560 S Maple St
Suite 130
Waconia, MN 55387-1733

Mailing address

560 S Maple St
Suite 130
Waconia, MN 55387-1733
Phone (952) 442-2137

Other identifiers 1

IdentifierTypeStateIssuer
526810900MedicaidMN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279497600000",
    "number": "1093703316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S MAPLE ST",
            "address_2": "SUITE 130",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871733",
            "telephone_number": "952-442-2137",
            "fax_number": "952-442-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S MAPLE ST",
            "address_2": "SUITE 130",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871733",
            "telephone_number": "952-442-2137",
            "fax_number": "952-442-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN OB/GYN LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2010-07-19",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "952-442-2137",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526810900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; 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.