Eric A Wingerson, D.O.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

0-122 Issued in ID

Practice address

1995 E 17TH St
St. #4
Idaho Falls, ID 83404-6493

Phone

(208) 524-3939

Fax

(208) 524-3950

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

GastroenterologyAlso: Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ewingerson632210@direct.emplifyhealth.org

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.

• Eric a. Wingerson, D.O. & Digestive Health Center, PC

  • Gastroenterology Physician
  • Idaho Falls, ID
  • NPI 1780766071
  NPD (past) Authorized official
• St Lukes Clinic - Wood River LLC

  • Internal Medicine Physician
  • Ketchum, ID
  • NPI 1972891604
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Wood River Medical Center LTD

  • Critical Access Hospital
  • Ketchum, ID
  • NPI 1508869470
  Care Compare affiliation

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1295738797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E 17TH ST",
            "address_2": "ST. #4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046493",
            "telephone_number": "208-524-3939",
            "fax_number": "208-524-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E 17TH ST",
            "address_2": "ST. #4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046493",
            "telephone_number": "208-524-3939",
            "fax_number": "208-524-3950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hospital Dr., Ste 201",
            "address_purpose": "LOCATION",
            "city": "Ketchum",
            "state": "ID",
            "postal_code": "83340",
            "country_code": "US",
            "telephone_number": "208-727-8888",
            "fax_number": "208-727-8889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINGERSON",
        "first_name": "ERIC",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2024-01-02",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "MEDPHYSCOMLIC114155",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "0-122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "710949800",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002708700",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEPTLHREVIntegrityHIMTechs@logan.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "320 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ashley Elizabeth Winward, COTA
• Jory Jarom Winward, DO
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• Brady Matthew Wirick, D,C,
• Shane Oliver Withers Jr., PHARMD, BCPS

• Gastroenterology Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Gastroenterology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.