Shawn Wadsworth, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

05-39265 Issued in KS

Practice address

7570 W. 21St St. N.
Building 1042 Suite a
Wichita, KS 67205-6720

Phone

(316) 854-3526

Fax

(316) 854-3511

NPI assigned

Mar 20, 2013

Last updated

May 14, 2020By 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 13

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS, ME3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Family Practice

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shawn.wadsworth.1@30520.direct.athenahealth.com

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.

• Doctor on Demand Professionals of Kansas, P.a.

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1881477339

  KS

  Medicare reassignment NPD
• Doctor on Demand Professionals P C

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174931448

  ME

  Medicare reassignment
• Emergent Care Plus, LLC

  dba NextCare Urgent Care

  • Urgent Care Clinic/Center
  • Lee's Summit, MO
  • NPI 1396923181
  Medicare reassignment

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1841532637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7570 W. 21ST ST. N.",
            "address_2": "BUILDING 1042 SUITE A",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051236",
            "telephone_number": "316-854-3526",
            "fax_number": "316-854-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7570 W. 21ST ST. N.",
            "address_2": "BUILDING 1042 SUITE A",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672056720",
            "telephone_number": "316-854-3526",
            "fax_number": "316-854-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2015016398",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-05296",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "64762",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60914447",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "41-321",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "007851",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036147727",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1957",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "11317",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "CDR.0000392",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11309988-1204",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO2940",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-39265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Wade, MD
• Laurinda Wade, CRNA
• Paul David Wade, RPH
• Teresa Wade, L.M.P.
• Katherine Ruth Wadsworth, PT, DPT
• Abdul Wadud, MD
• Saeed E Wadud, MD
• Jason E Wagle, DDS
• Christine Michelle Wagner, LSCSW
• Debra E Wagner, ARNP, CCRN

• Family Medicine Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.