Individual provider Active NPI

Richard S Wayne, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • San Antonio, TX
National Provider Identifier
1669408779
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
18077 Issued in MS
Practice address
333 N Santa Rosa St
San Antonio, TX 78207-3108
Phone
(210) 704-3321
Fax
(210) 704-4527
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 18077 MS Primary

Addresses

Primary practice location

333 N Santa Rosa St
San Antonio, TX 78207-3108

Mailing address

315 N San Saba Ste 1003
San Antonio, TX 78207-3100
Phone (210) 704-3879

Other identifiers 2

IdentifierTypeStateIssuer
13622114MedicaidTX
136226115OtherTXCSCHN

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Pediatric Emergency Medicine Past Accepting new patients
Texas Children'S Physician Group Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1669408779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA STE 1003",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073100",
            "telephone_number": "210-704-3879",
            "fax_number": "210-704-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-3321",
            "fax_number": "210-704-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYNE",
        "first_name": "RICHARD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MS",
            "license": "18077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13622114",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSCHN",
            "identifier": "136226115",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.