Waverly Medical Practice,Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

35024770 Issued in OH

Legal business name

WAVERLY MEDICAL PRACTICE,INC.

Practice address

207 St Anns LN
Waverly, OH 45690-1040

Phone

(740) 708-5478

Fax

(740) 947-5720

NPI assigned

Nov 28, 2007

Last updated

Mar 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Arthur Wilkinson, M.D.NPI 1457435851

Title

Owner

Phone

(740) 947-2383

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth A Wilkinson, M.D.

  • General Practice Physician
  • Waverly, OH
  • NPI 1457435851
  Authorized official Same address or phone

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206057600000",
    "number": "1386826766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SAINT ANNS LN",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901040",
            "telephone_number": "740-708-5478",
            "fax_number": "740-947-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 ST ANNS LN",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901040",
            "telephone_number": "740-708-5478",
            "fax_number": "740-947-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY MEDICAL PRACTICE,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2008-03-21",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-947-2383",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "35024770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9470880",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Waverly Care Center Inc2 (Village Health Center)
• Waverly Care Center, Inc (National Church Residences Bristol Village)
• Waverly Care Center, Inc (National Church Residences Bristol Village)
• Waverly City Board of Education
• Waverly Family Dental
• Christina Wayt
• David Stahler Weiss
• Wellcare Facility LLC
• Anthony Shane Wells, A.T.,C.
• Brittany Nicole Wells, CDCA

• Primary Care Clinic/Center in Waverly, OH
• Providers in Waverly, OH by specialty
• Primary Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.