Active NPI
David A Wassil, DO
- Family Medicine Physician
- Gibsonburg, OH
National Provider Identifier
1689647604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34003982
- Practice address
- 365 Windsor Lane
Suite 2
Gibsonburg, OH 43431 - Phone
- (419) 637-2185
- Fax
- (419) 637-2790
- NPI assigned
- Feb 9, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34003982 | OH | Primary |
Addresses
Primary practice location
365 Windsor Lane
Suite 2
Gibsonburg, OH 43431
Mailing address
365 Windsor Lane
Suite 2
Gibsonburg, OH 43431
Phone (419) 637-2185
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000154663 | Other | OH | ANTHEM |
| 0594843 | Medicaid | OH | |
| 02179 | Other | OH | PARAMOUNT |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3982 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212105600000",
"number": "1689647604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 WINDSOR LANE",
"address_2": "SUITE 2",
"city": "GIBSONBURG",
"state": "OH",
"postal_code": "43431",
"telephone_number": "419-637-2185",
"fax_number": "419-637-2790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 WINDSOR LANE",
"address_2": "SUITE 2",
"city": "GIBSONBURG",
"state": "OH",
"postal_code": "43431",
"telephone_number": "419-637-2185",
"fax_number": "419-637-2790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSIL",
"first_name": "DAVID",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2008-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34003982",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000154663",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0594843",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT",
"identifier": "02179",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gibsonburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.