Individual provider Active NPI

Joel E Waymire, MD

  • Pediatrics Physician
  • Windsor Heights, IA
National Provider Identifier
1164409140
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25436 Issued in IA
Practice address
974 73Rd St
Suite 30
Windsor Heights, IA 50312-1024
Phone
(515) 224-4993
Fax
(515) 224-1505
NPI assigned
Dec 29, 2005
Last updated
May 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25436 IA Primary

Addresses

Primary practice location

974 73Rd St
Suite 30
Windsor Heights, IA 50312-1024

Mailing address

974 73Rd St
Suite 30
Windsor Heights, IA 50312-1024
Phone (515) 224-4993

Other identifiers 2

IdentifierTypeStateIssuer
0042309MedicaidIA
1164409140MedicaidIA

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
25436IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Hospital Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1164409140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 73RD ST",
            "address_2": "SUITE 30",
            "city": "WINDSOR HEIGHTS",
            "state": "IA",
            "postal_code": "503121024",
            "telephone_number": "515-224-4993",
            "fax_number": "515-224-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 73RD ST",
            "address_2": "SUITE 30",
            "city": "WINDSOR HEIGHTS",
            "state": "IA",
            "postal_code": "503121024",
            "telephone_number": "515-224-4993",
            "fax_number": "515-224-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYMIRE",
        "first_name": "JOEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "25436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0042309",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164409140",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Heights, IA

Sources for this page

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