Individual provider Active NPI

David L Wonnell, PA-C

  • Physician Assistant
  • West Des Moines, IA
National Provider Identifier
1851378533
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001548 Issued in IA
Practice address
105 Valley West Dr
Suite 100
West Des Moines, IA 50265-3902
Phone
(515) 223-4368
Fax
(515) 453-2368
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001548 IA Primary
Surgical Physician Assistant 363AS0400X 001548 IA

Addresses

Primary practice location

105 Valley West Dr
Suite 100
West Des Moines, IA 50265-3902

Mailing address

105 Valley West Dr
Suite 100
West Des Moines, IA 50265-3902
Phone (515) 223-4368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040505000084 IA Practitioner - Physician Assistant 7315935665

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa ENT Center PLLCGroup PAC ID 6406007608, 13 clinicians

Practice addresses (Care Compare)

105 Valley W Dr
Suite 100
West Des Moines, IA 50265-3902
Phone (515) 223-4368

Hospital & facility affiliations

  • Pella Regional Health Center Hospital, Pella, IA, CCN 161367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001548IAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Orthopaedic Center, P.C. Surgical CurrentSince Oct 1, 2007 Accepting new patients
ENT Clinic of Iowa, PC PastSince Feb 1, 2006 Accepting new patients
Boone County Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dwonnell@826.securemail.prognocis.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1851378533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 VALLEY WEST DR",
            "address_2": "SUITE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502653902",
            "telephone_number": "515-223-4368",
            "fax_number": "515-453-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VALLEY WEST DR",
            "address_2": "SUITE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502653902",
            "telephone_number": "515-223-4368",
            "fax_number": "515-453-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONNELL",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001548",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "001548",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.