Active NPI
Joshua Wigdahl, PA-C
- Physician Assistant
- Derby, KS
National Provider Identifier
1457729097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15-01821
- Practice address
- 606 N Mulberry Rd
Derby, KS 67037-3532 - Phone
- (316) 788-3787
- NPI assigned
- Sep 14, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15-01821 | KS | Primary |
Addresses
Primary practice location
606 N Mulberry Rd
Derby, KS 67037-3532
Mailing address
2414 E Mesita St
Wichita, KS 67211-3738
Phone (316) 200-2080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
606 N Mulberry Rd
Derby, KS 67037-3532
Phone (316) 788-3787
Hospital & facility affiliations
- Interim Healthcare of Wichita
- Rock Regional Hospital, LLC
- Wesley Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-01821 | KS | MD | Physician Assistant |
Interoperability endpoints
- josh.wigdahl@tfmc.directbygreenway.com
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Derby, KS
- NPI 1659472306
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Wichita, KS
- NPI 1548264229
-
- General Acute Care Hospital
- Wichita, KS
- NPI 1447299649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1457729097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2414 E MESITA ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672113738",
"telephone_number": "316-200-2080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 N MULBERRY RD",
"city": "DERBY",
"state": "KS",
"postal_code": "670373532",
"telephone_number": "316-788-3787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGDAHL",
"first_name": "JOSHUA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-14",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "15-01821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derby, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.