Samir R Wahby, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

23372 Issued in IA

Practice address

2700 1St Ave S
Suite 100
Fort Dodge, IA 50501-4306

Phone

(515) 955-6767

Fax

(515) 576-8581

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1659327872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 1ST AVE S",
            "address_2": "SUITE 100",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 1ST AVE S",
            "address_2": "SUITE 100",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014306",
            "telephone_number": "515-955-6767",
            "fax_number": "515-576-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHBY",
        "first_name": "SAMIR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IA",
            "license": "23372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "20058",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS",
            "identifier": "4848",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200584",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Vonsak, FNP
• Traci Marie Vote, IADC
• Victoria Renee Vote
• Richard Votta, MD
• April M Wagner, ARNP-FNP-C
• Wal-Mart Stores, Inc.
• Walgreen Co
• Ryan Walker
• Kelli P Wallace, MD
• Lincoln R Wallace, MD

• Sports Medicine (Orthopaedic Surgery) Physician in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.

Verify at the official NPI Registry.