Individual provider Active NPI

David F Wender, MD

  • Neonatal-Perinatal Medicine Physician
  • Flowood, MS
National Provider Identifier
1104925882
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
09575 Issued in MS
Practice address
5 River Bend Place
Suite C
Flowood, MS 39232
Phone
(601) 975-7345
Fax
(769) 251-5429
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 09575 MS Primary

Addresses

Primary practice location

5 River Bend Place
Suite C
Flowood, MS 39232

Mailing address

P O Box 320039
Flowood, MS 39232
Phone (601) 957-7345

Other identifiers 3

IdentifierTypeStateIssuer
09575OtherMSMS STATE MEDICAL LIC
0122948MedicaidMS
00122948MedicaidMS

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
09575MSMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
River Oaks Hospital LLC Past Accepting new patients
Roh LLC Past Accepting new patients
Newborn Associates P a Neonatal-Perinatal Medicine PastSince Sep 15, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dwender2548731@direct.casso.us.com

Organizations & group practices 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1104925882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 320039",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-957-7345",
            "fax_number": "769-251-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RIVER BEND PLACE",
            "address_2": "SUITE C",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-975-7345",
            "fax_number": "769-251-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDER",
        "first_name": "DAVID",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MS",
            "license": "09575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS STATE MEDICAL LIC",
            "identifier": "09575",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122948",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122948",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; 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.