Active NPI
David Anton Wold, M.D.
- Ophthalmology Physician
- Coeur D Alene, ID
National Provider Identifier
1194861278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- M3141
- Practice address
- 1814 Lincoln Way
Coeur D Alene, ID 83814-2540 - Phone
- (208) 667-2531
- Fax
- (208) 765-9385
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | M3141 | ID | Primary |
Addresses
Primary practice location
1814 Lincoln Way
Coeur D Alene, ID 83814-2540
Mailing address
1814 Lincoln Way
Coeur D Alene, ID 83814-2540
Phone (208) 667-2531
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004011500 | Medicaid | ID | |
| 1518003516 | Other | NORTH IDAHO CATARACT & LA | |
| 000010006141 | Other | ID | REGENCE BLUE SHIELD OF ID |
| 31419 | Other | ID | BLUE CROSS OF IDAHO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| M3141 | ID | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278374400000",
"number": "1194861278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1814 LINCOLN WAY",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142540",
"telephone_number": "208-667-2531",
"fax_number": "208-765-9385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 LINCOLN WAY",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142540",
"telephone_number": "208-667-2531",
"fax_number": "208-765-9385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLD",
"first_name": "DAVID",
"middle_name": "ANTON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2010-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "ID",
"license": "M3141",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004011500",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH IDAHO CATARACT & LA",
"identifier": "1518003516",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010006141",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "31419",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.