Active NPI
Douglas Lee Wheeler, D.O.
- Emergency Medicine Physician
- Jefferson City, MO
National Provider Identifier
1508806217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DOR7792
- Practice address
- 1125 Madison St
Jefferson City, MO 65101-5227 - Phone
- (573) 632-5000
- NPI assigned
- Jun 8, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | DOR7792 | MO | Primary |
Addresses
Primary practice location
1125 Madison St
Jefferson City, MO 65101-5227
Mailing address
PO Box 633819
Cincinnati, OH 45263-0001
Phone (865) 292-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00322461 | Other | MO | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DOR7792 | MO | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194220800000",
"number": "1508806217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 633819",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452630001",
"telephone_number": "865-292-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 MADISON ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651015227",
"telephone_number": "573-632-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "DOUGLAS",
"middle_name": "LEE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2007-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "DOR7792",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00322461",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.