Lawrence Evan Wibbels, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MDR8G40 Issued in MO

Practice address

400 Parkland Dr
Farmington, MO 63640-2906

Phone

(573) 756-8000

Fax

(576) 756-8288

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Jefferson Memorial Surgical Partners LLC

  • Ambulatory Surgical Clinic/Center
  • Festus, MO
  • NPI 1548224207
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1508921651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 WATSON RD",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636018123",
            "telephone_number": "573-760-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARKLAND DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402906",
            "telephone_number": "573-756-8000",
            "fax_number": "576-756-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBBELS",
        "first_name": "LAWRENCE",
        "middle_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "R8G40",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "MDR8G40",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202404877",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Westmount Dental Arts
• Joann L Weston, M.A.,L.P.C.
• Laticia Weston, LCSW
• Hannah White
• Teresa Christine Whited, BS
• Jorgen C Wibskov, HIS
• Richard Wild
• Virginia Lee Wild
• Douglas E Wiles
• Kathryn Sue Wiles, DPT

• Anesthesiology Physician in Farmington, MO
• Providers in Farmington, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.