Active NPI
Thomas Ernest Wallin, M.D.
- Obstetrics & Gynecology Physician
- Lemoyne, PA
National Provider Identifier
1730151705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD024819E
- Practice address
- 1 Lemoyne SQ
Suite 201
Lemoyne, PA 17043-1230 - Phone
- (717) 737-4511
- Fax
- (717) 909-6659
- NPI assigned
- Feb 3, 2006
- Last updated
- Aug 15, 2007
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD024819E | PA | Primary |
Addresses
Primary practice location
1 Lemoyne SQ
Suite 201
Lemoyne, PA 17043-1230
Mailing address
1 Lemoyne SQ
Suite 201
Lemoyne, PA 17043-1230
Phone (717) 737-4511
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4544428 | Other | PA | AETNA PPO PROVIDER NUMBER |
| 483666 | Other | PA | AETNA HMO PROVIDER NUMBER |
| 50026635 | Other | PA | CAPITAL BLUE CROSS |
| 117566 | Other | PA | HIGHMARK BLUE SHIELD |
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": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187136000000",
"number": "1730151705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LEMOYNE SQ",
"address_2": "SUITE 201",
"city": "LEMOYNE",
"state": "PA",
"postal_code": "170431230",
"telephone_number": "717-737-4511",
"fax_number": "717-909-6659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LEMOYNE SQ",
"address_2": "SUITE 201",
"city": "LEMOYNE",
"state": "PA",
"postal_code": "170431230",
"telephone_number": "717-737-4511",
"fax_number": "717-909-6659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLIN",
"first_name": "THOMAS",
"middle_name": "ERNEST",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-03",
"last_updated": "2007-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MD024819E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO PROVIDER NUMBER",
"identifier": "4544428",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO PROVIDER NUMBER",
"identifier": "483666",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50026635",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "117566",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lemoyne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.