Individual provider Active NPI

Wayne E Richenbacher, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Iowa City, IA
National Provider Identifier
1144213356
Registry record updated Dec 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
29203 Issued in IA
Practice address
540 E Jefferson St
Suite 401
Iowa City, IA 52245-2477
Phone
(319) 688-7733
Fax
(319) 688-7734
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2012

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 29203 IA Primary

Addresses

Primary practice location

540 E Jefferson St
Suite 401
Iowa City, IA 52245-2477

Mailing address

PO Box 2027
Iowa City, IA 52244-2027
Phone (319) 339-3541

Other identifiers 2

IdentifierTypeStateIssuer
0099622MedicaidIA
11910OtherIAWELLMARK BCBS

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

State licenses

LicenseStateTypeSpecialty
29203IAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Interoperability endpoints

  • Direct secure messaging: wrichenbacher13835@uihcdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356307200000",
    "number": "1144213356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2027",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522442027",
            "telephone_number": "319-339-3541",
            "fax_number": "319-358-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E JEFFERSON ST",
            "address_2": "SUITE 401",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452477",
            "telephone_number": "319-688-7733",
            "fax_number": "319-688-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHENBACHER",
        "first_name": "WAYNE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2012-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IA",
            "license": "29203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099622",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "11910",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2012; 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.