Individual provider Active NPI

Robert L Vawter, MD

  • Rheumatology Physician
  • Wheeling, WV
National Provider Identifier
1609876408
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
16074 Issued in WV
Practice address
30 Medical Park
101
Wheeling, WV 26003-6391
Phone
(304) 242-1100
Fax
(304) 242-9810
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 16074 WV Primary

Addresses

Primary practice location

30 Medical Park
101
Wheeling, WV 26003-6391

Mailing address

30 Medical Park
Wheeling, WV 26003-6391
Phone (304) 242-1100

Other identifiers 1

IdentifierTypeStateIssuer
0074481000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20101004000230 WV Practitioner - Rheumatology 8729270277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Medical Park
Suite 101
Wheeling, WV 26003-6391
Phone (304) 242-1100

Hospital & facility affiliations

National Provider Directory

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

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1609876408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MEDICAL PARK",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036391",
            "telephone_number": "304-242-1100",
            "fax_number": "304-242-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDICAL PARK",
            "address_2": "101",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036391",
            "telephone_number": "304-242-1100",
            "fax_number": "304-242-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAWTER",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WV",
            "license": "16074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074481000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.