Individual provider Active NPI

William B Wheeler, M.D.

  • Pediatric Pulmonology Physician
  • Minneapolis, MN
National Provider Identifier
1417959362
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
31512 Issued in MN
Practice address
2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289
Phone
(612) 813-3300
Fax
(612) 813-3349
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 31512 MN
Pediatric Pulmonology Physician 2080P0214X 31512 MN Primary

Addresses

Primary practice location

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289

Mailing address

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289
Phone (612) 813-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420001226 MN Practitioner - Pediatric Medicine 9436125556 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31512MNMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children'S Specialty Healthcare CurrentSince Feb 1, 2014 Accepting new patients
Gillette Children'S Specialty Healthcare CurrentSince Feb 1, 2014 Accepting new patients
Children'S Respiratory & Critical Care Specialists. P.a. Pediatric Pulmonology CurrentSince Aug 10, 2004 Accepting new patients
Gillette Children'S Specialty Healthcare Past Accepting new patients

Locations

2530 Chicago Ave
Ste 400
Minneapolis, MN 55404
Phone (612) 813-3300

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1417959362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MN",
            "license": "31512",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MN",
            "license": "31512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.