Benjamin Lafayette Wirt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-90 Issued in AL

Practice address

2871 Acton Rd Ste 100
Vestavia, AL 35243

Phone

(205) 716-6900

Fax

(205) 939-0293

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ben L. Wirt Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1265488209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 ACTON RD STE 100",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432560",
            "telephone_number": "205-716-6900",
            "fax_number": "205-939-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 ACTON RD STE 100",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "35243",
            "telephone_number": "205-716-6900",
            "fax_number": "205-939-0293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19thStreet South",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "35233",
            "country_code": "US",
            "telephone_number": "205-934-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIRT",
        "first_name": "BENJAMIN",
        "middle_name": "LAFAYETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA-90",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA-90",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000042296",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEN",
            "last_name": "WIRT",
            "middle_name": "L.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Cameron A Wlaschin, PHARMD
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• Physician Assistant in Vestavia, AL
• Providers in Vestavia, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.