Active NPI
John C Wiggans, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Cape Girardeau, MO
National Provider Identifier
1669584603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 2001001485
- Practice address
- 3250 Gordonville Rd
Suite 358
Cape Girardeau, MO 63703-5056 - Phone
- (573) 331-3155
- Fax
- (573) 331-5096
- NPI assigned
- Aug 31, 2006
- 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 |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 2001001485 | MO | Primary |
Addresses
Primary practice location
3250 Gordonville Rd
Suite 358
Cape Girardeau, MO 63703-5056
Mailing address
PO Box 843225
Kansas City, MO 64184-3225
Phone (708) 633-1234
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669584603 | Medicaid | IL | |
| P00772953 | Other | MO | RR MCR |
| 454668 | Other | MO | HEALTHLINK |
| 205382807 | Medicaid | MO | |
| 604417 | Other | MO | BCBS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266278400000",
"number": "1669584603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 843225",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641843225",
"telephone_number": "708-633-1234",
"fax_number": "708-342-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 GORDONVILLE RD",
"address_2": "SUITE 358",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637035056",
"telephone_number": "573-331-3155",
"fax_number": "573-331-5096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGANS",
"first_name": "JOHN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2010-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MO",
"license": "2001001485",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1669584603",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "P00772953",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "454668",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "205382807",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "604417",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.