Active NPI
Edward Theodore Wasco, M.A.
- Children's Hospital
- Neenah, WI
National Provider Identifier
1649480443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Children's Hospital
- License
- 1930-123
- Practice address
- 130 2ND St
Neenah, WI 54956-2883 - Phone
- (920) 969-7905
- Fax
- (920) 969-7969
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Children's Hospital | 282NC2000X | 1930-123 | WI | Primary |
Addresses
Primary practice location
130 2ND St
Neenah, WI 54956-2883
Mailing address
623 Haylett St
Neenah, WI 54956-4105
Phone (920) 725-1892
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1930-123 | WI | MD | Children's Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649480443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 HAYLETT ST",
"city": "NEENAH",
"state": "WI",
"postal_code": "549564105",
"telephone_number": "920-725-1892",
"fax_number": "920-725-1892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 2ND ST",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562883",
"telephone_number": "920-969-7905",
"fax_number": "920-969-7969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASCO",
"first_name": "EDWARD",
"middle_name": "THEODORE",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "282NC2000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Children",
"state": "WI",
"license": "1930-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.