Adam Wahlstrom, D.O

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

10389523-1204 Issued in UT

Practice address

1240 E 100 S
St George, UT 84790-3001

Phone

(801) 448-8619

NPI assigned

Mar 12, 2014

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

Enrolled in UT

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awahlstrom714716@directa.mercy.net

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154

  Single Specialty

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1790291243

  Single Specialty

  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • St George, UT
  • NPI 1366452880
  NPD (past)
• Jerry D Twiggs MD PC

  • Pediatric Adolescent Medicine Physician
  • St George, UT
  • NPI 1578763702

  Single Specialty

  NPD (past)
• Night Light Pediatrics LLC

  • Pediatric Adolescent Medicine Physician
  • St George, UT
  • NPI 1295855914

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881010023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 E 100 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847903001",
            "telephone_number": "801-628-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 E 100 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847903001",
            "telephone_number": "801-448-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLSTROM",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-12",
        "last_updated": "2023-03-07",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "UT",
            "license": "10389523-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Wagner, MD
• William J Wagner, MD
• Woodrow Wilson Wagner III, D.M.D.
• John Wahlen
• Wade Lee Wahlquist, RN, BSN
• Ceri Wait
• Erin Waite
• Richelle Wakefield
• Wal-Mart Stores, Inc
• Cassandra Waldo, LCSW

• Pediatric Adolescent Medicine Physician in St George, UT
• Providers in St George, UT by specialty
• Pediatric Adolescent Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.