Active NPI
Donald Keith Wonder II, M.D.
- Surgery Physician
- Neosho, MO
National Provider Identifier
1578511200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- R1E13
- Practice address
- 336 S Jefferson St
Neosho, MO 64850-1769 - Phone
- (417) 455-4200
- NPI assigned
- May 5, 2006
- Last updated
- May 9, 2017
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | R1E13 | MO | Primary |
Addresses
Primary practice location
336 S Jefferson St
Neosho, MO 64850-1769
Mailing address
PO Box 3810
Joplin, MO 64803-3810
Phone (417) 455-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020007605 | Medicaid | MO |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1E13 | MO | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1578511200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3810",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648033810",
"telephone_number": "417-455-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "336 S JEFFERSON ST",
"city": "NEOSHO",
"state": "MO",
"postal_code": "648501769",
"telephone_number": "417-455-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONDER",
"first_name": "DONALD",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "R1E13",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2020007605",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Neosho, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.