Edward Lyle Wegner, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

1305 Issued in SD

Practice address

401 9TH Ave NW
Watertown, SD 57201-1548

Phone

(605) 882-7749

NPI assigned

May 3, 2006

Last updated

Jul 16, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

• Watertown Pathology PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Watertown, SD
  • NPI 1114966892
  NPD (past) Authorized official
• Diagnostic Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Watertown, SD
  • NPI 1871538504
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1437117173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 875",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572010875",
            "telephone_number": "605-882-5753",
            "fax_number": "605-882-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGNER",
        "first_name": "EDWARD",
        "middle_name": "LYLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SD",
            "license": "1305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600332",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Watertown SD Skilled Nursing Facility LLC (Avantara Watertown)
• Watertown Wellness and Chiropractic
• Wayne E Snyder MD, PC (Snyder Eye Clinic)
• We Care Transportation LLC
• Erin Kay Weber, PA-C
• Weiss Eye Care Clinic
• Abby Rose Weiss
• Melanie Dawn Weiss, OD
• Joyce Wendel
• Werner Home Medical Care, Inc.

• Anatomic Pathology & Clinical Pathology Physician in Watertown, SD
• Providers in Watertown, SD by specialty
• Anatomic Pathology & Clinical Pathology Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.