W. Wallace Webster MD LLC

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

Legal business name

W. WALLACE WEBSTER MD LLC

Practice address

620 Commercial Ave Ste a
Coos Bay, OR 97420-1846

Phone

(541) 297-5342

Fax

(541) 808-0415

NPI assigned

Jun 8, 2020

Last updated

Jun 8, 2020By 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

Dr. William Wallace Webster III, MDNPI 1528166287

Title

Owner

Phone

(541) 297-5342

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22276/brand/1/csg/1/fhir/r4

Practitioners 2

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.

• William Wallace Webster, MD

  • Otolaryngology Physician
  • Coos Bay, OR
  • NPI 1528166287
  Medicare reassignment NPD Authorized official
• Jennifer Emma Allred

  • Adult Health Nurse Practitioner
  • Coos Bay, OR
  • NPI 1124078407
  NPD

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1407470214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 COMMERCIAL AVE STE A",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201846",
            "telephone_number": "541-297-5342",
            "fax_number": "541-808-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 COMMERCIAL AVE STE A",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201846",
            "telephone_number": "541-297-5342",
            "fax_number": "541-808-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. WALLACE WEBSTER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-297-5342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274244",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul C Vitt, DO
• Patrick Beauregard Vondippe, MD
• Joanna Renee Vonseggern, PTA
• Benjamin Levi Voth, D.C.
• Swetha Vutukuri
• Eric G Waelbroeck, MD
• Gail Loree Wahl, PH.D.
• James M. Wahl
• Wal-Mart Stores Inc (Wal-Mart Pharmacy 10-2301)
• Krystal Cathleen Walden

• Facial Plastic Surgery Physician in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Facial Plastic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.