Theodore A Waflart, M.D.

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

01027456A Issued in IN

Practice address

800 W 9TH St
Jasper, IN 47546-2514

Phone

(812) 481-5750

Fax

(812) 481-5763

NPI assigned

Sep 28, 2006

Last updated

Jun 23, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: theodore.waflart.1@24032.direct.athenahealth.com

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.

• Dubois County Auditor

  • Public Health or Welfare Agency
  • Jasper, IN
  • NPI 1497854095
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1316039498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1028",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475471028",
            "telephone_number": "812-481-8493",
            "fax_number": "812-481-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 9TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462514",
            "telephone_number": "812-481-5750",
            "fax_number": "812-481-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAFLART",
        "first_name": "THEODORE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "IN",
            "license": "01027456A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10010907A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Vonderheide, RPH
• Kelley M Vonderheide, DPT
• Benjamin Tristan Vonderschmitt, PSYS.
• Melody Voyles, LCSW
• Madisyn Wade, OTR/L
• Britney Wagler, MSW-LCSW
• James Wesley Wagler, O.D.
• Shayna Wagler, PMHNP-BC
• Wagner Family Dental
• Tina M Wahl

• Sports Medicine (Emergency Medicine) Physician in Jasper, IN
• Providers in Jasper, IN by specialty
• Sports Medicine (Emergency Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.

Verify at the official NPI Registry.