NPIMap

Organization Active NPI

Sleep-Wake Disorder Center of Daytona PA

  • Sleep Medicine (Internal Medicine) Physician
  • Daytona Beach, FL
National Provider Identifier
1699021295
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
SLEEP-WAKE DISORDER CENTER OF DAYTONA PA
Practice address
810 Wildwood St
Ste 1
Daytona Beach, FL 32117-4568
Phone
(386) 258-7100
Fax
(386) 253-1843
NPI assigned
Aug 1, 2012
Last updated
Jul 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Authorized official

Name
Wahba W Wahba, MDNPI 1366541997
Title
Owner
Phone
(386) 258-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NU
Pulmonary Disease Physician 207RP1001X NU
Pediatrics Physician 208000000X NU
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU Primary

Addresses

Primary practice location

810 Wildwood St
Ste 1
Daytona Beach, FL 32117-4568

Mailing address

810 Wildwood St
Ste 1
Daytona Beach, FL 32117-4568
Phone (386) 258-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120913000329 FL Part B Supplier - Clinic/Group Practice 4789832916 Receives reassigned benefits from 3 practitioners
Practice locations: Daytona Beach, FL; Ormond Beach, FL; Palm Coast, FL; Port Orange, FL

National Provider Directory

National Provider Directory

Locations

810 Wildwood St
#1
Daytona Beach, FL 32117
Phone (386) 258-7100

2836 Enterprise Rd
Debary, FL 32713
Phone (386) 258-7100

621 S Nova Rd
Ormond Beach, FL 32174
Phone (386) 258-7100

4869 Palm Coast Pkwy NW
Unit 45
Palm Coast, FL 32137
Phone (386) 258-7100

3949 S Nova Rd
Port Orange, FL 32127
Phone (386) 258-7100

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1699021295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 WILDWOOD ST",
            "address_2": "STE 1",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174568",
            "telephone_number": "386-258-7100",
            "fax_number": "386-253-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 WILDWOOD ST",
            "address_2": "STE 1",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174568",
            "telephone_number": "386-258-7100",
            "fax_number": "386-253-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP-WAKE DISORDER CENTER OF DAYTONA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-01",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "WAHBA",
        "authorized_official_first_name": "WAHBA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-258-7100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.