NPIMap

Individual provider Active NPI

Todd Joseph Wannemuehler, M.D.

  • Otolaryngology Physician
  • Evansville, IN
National Provider Identifier
1447519178
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01080398A Issued in IN
Practice address
350 W Columbia St Ste 310
Evansville, IN 47710
Phone
(812) 425-2646
Fax
(812) 467-7209
NPI assigned
May 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 55475 TN
Otolaryngology Physician 207Y00000X 01080398A IN Primary

Addresses

Primary practice location

350 W Columbia St Ste 310
Evansville, IN 47710

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 425-2646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180807001977 IN Practitioner - Otolaryngology 9739325564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

4015 Gateway Blvd
Newburgh, IN 47630-8925
Phone (812) 858-9400

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • Gibson General Hospital Hospital, Princeton, IN, CCN 151319
  • Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056
  • Ferrell Hospital Community Foundations Hospital, Eldorado, IL, CCN 141324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01080398AINMDOtolaryngology Physician
55475TNMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc CurrentSince Sep 1, 2018 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic, Inc. Otolaryngology CurrentSince Sep 1, 2018 Accepting new patients
Deaconess Clinic, Inc Past Accepting new patients

Locations

350 W Columbia St
Ste 310
Evansville, IN 47710
Phone (812) 425-2646

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

350 W Columbia St
Ste 200
Evansville, IN 47710
Phone (812) 425-2646

4015 Gateway Blvd
Newburgh, IN 47630
Phone (812) 858-6244

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: twannamuehler202189@direct.deaconess.com

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1447519178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-425-2646",
            "fax_number": "812-467-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W COLUMBIA ST STE 310",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47710",
            "telephone_number": "812-425-2646",
            "fax_number": "812-467-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANNEMUEHLER",
        "first_name": "TODD",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "55475",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01080398A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.