Peter Dwight Wirtz, M.D.

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

17314 Issued in IA

Practice address

7601 Office Plaza Dr N
Suite 115
W Des Moines, IA 50266-2338

Phone

(515) 278-5811

Fax

(515) 981-0420

NPI assigned

Feb 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stadia Sports Medicine PC

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • West Des Moines, IA
  • NPI 1962453274
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689700593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 355",
            "city": "NORWALK",
            "state": "IA",
            "postal_code": "502110355",
            "telephone_number": "515-278-5811",
            "fax_number": "515-981-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 OFFICE PLAZA DR N",
            "address_2": "SUITE 115",
            "city": "W DES MOINES",
            "state": "IA",
            "postal_code": "502662338",
            "telephone_number": "515-278-5811",
            "fax_number": "515-981-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTZ",
        "first_name": "PETER",
        "middle_name": "DWIGHT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "IA",
            "license": "17314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley D Hammer, M.D.
• Aidan Pearl, OD
• Monique P Root, O.D.
• Tobin Optical Center
• Usv Optical Inc

• Adult Reconstructive Orthopaedic Surgery Physician in W Des Moines, IA
• Providers in W Des Moines, IA by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Iowa

• 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.

Verify at the official NPI Registry.