NPIMap

Organization Active NPI

Dr. Joe Wommack, P.a.

  • General Practice Dentistry
  • Parsons, KS
National Provider Identifier
1558586404
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5853 Issued in KS
Legal business name
DR. JOE WOMMACK, P.A.
Practice address
1701 Washington Ave
Parsons, KS 67357-3204
Phone
(620) 421-0980
NPI assigned
Apr 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joe B WommackNPI 1225139207
Title
Owner Dentist
Phone
(620) 421-0980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5853 KS Primary

Addresses

Primary practice location

1701 Washington Ave
Parsons, KS 67357-3204

Mailing address

1701 Washington Ave
Parsons, KS 67357-3204
Phone (620) 421-0980

Other identifiers 2

IdentifierTypeStateIssuer
5853OtherKSKS DENTAL LICENSE
8345OtherKSBCBS PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

1701 Washington Ave
Parsons, KS 67357
Phone (620) 421-0980

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558586404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WASHINGTON AVE",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673573204",
            "telephone_number": "620-421-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 WASHINGTON AVE",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673573204",
            "telephone_number": "620-421-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOE WOMMACK, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOMMACK",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "620-421-0980",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "5853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KS DENTAL LICENSE",
            "identifier": "5853",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "8345",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsons, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.