Active NPI
David R. Wenner, D.O.
- Family Medicine Physician
- Harrisburg, PA
National Provider Identifier
1528044674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS005483-L
- Practice address
- 2300 Vartan Way Ste 270
Harrisburg, PA 17110-9720 - Phone
- (717) 221-7890
- Fax
- (717) 221-7891
- NPI assigned
- Dec 21, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | OS005483L | PA | |
| Family Medicine Physician | 207Q00000X | OS005483-L | PA | Primary |
Addresses
Primary practice location
2300 Vartan Way Ste 270
Harrisburg, PA 17110-9720
Mailing address
2300 Vartan Way Ste 270
Harrisburg, PA 17110-9720
Phone (717) 221-7890
Other practice location 1
2300 Vartan Way Ste 270
Harrisburg, PA 17110-9720
Phone (717) 221-7890 ext. 111
Other practice location 2
1112 Day Star Dr
Harrisburg, PA 17111-3741
Phone (717) 649-8743
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10980830001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS005483-L | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home for the Friendless | Current | Accepting new patients |
Locations
2300 Vartan Way
Ste 270
Harrisburg, PA 17110
Phone (717) 221-7890
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.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Harrisburg, PA
- NPI 1699430884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644451200000",
"number": "1528044674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 VARTAN WAY STE 270",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171109720",
"telephone_number": "717-221-7890",
"fax_number": "717-221-7891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 VARTAN WAY STE 270",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171109720",
"telephone_number": "717-221-7890",
"fax_number": "717-221-7891"
}
],
"practiceLocations": [
{
"address_1": "2300 Vartan Way Ste 270",
"address_purpose": "LOCATION",
"city": "Harrisburg",
"state": "PA",
"postal_code": "171109720",
"country_code": "US",
"telephone_number": "717-221-7890 x111",
"fax_number": "717-221-7891",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1112 Day Star Dr",
"address_purpose": "LOCATION",
"city": "Harrisburg",
"state": "PA",
"postal_code": "171113741",
"country_code": "US",
"telephone_number": "717-649-8743",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WENNER",
"first_name": "DAVID",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-21",
"last_updated": "2022-02-10",
"certification_date": "2021-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207QH0002X",
"taxonomy_group": "",
"desc": "Family Medicine, Hospice and Palliative Medicine",
"state": "PA",
"license": "OS005483L",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OS005483-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10980830001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.