Individual provider Active NPI

David R. Wenner, D.O.

  • Family Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1528044674
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS005483-L Issued in PA
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

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
10980830001MedicaidPA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080818000047 PA Practitioner - Hospice/Palliative CarePractitioner - Family Practice 0547335168 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS005483-LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Home for the Friendless CurrentSince Jan 14, 2022 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.

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

Verify at the official NPI Registry.