Individual provider Active NPI

Adam D Wheeler, MD

  • Pediatrics Physician
  • Columbia, MO
National Provider Identifier
1891803086
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2009003448 Issued in MO
Practice address
200 Corporate Lake Dr
Columbia, MO 65203-7172
Phone
(573) 814-1170
Fax
(573) 530-1037
NPI assigned
Aug 28, 2006
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2009003448 MO Primary

Addresses

Primary practice location

200 Corporate Lake Dr
Columbia, MO 65203-7172

Mailing address

200 Corporate Lake Dr
Columbia, MO 65203-7172
Phone (573) 814-1170

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090318000646 MO Practitioner - Pediatric MedicinePractitioner - General Practice 5395802318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: General Practice
Education
University of Missouri, Columbia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Big Tree Medical Group LLCGroup PAC ID 6507232543, 9 clinicians

Practice addresses (Care Compare)

200 Corporate Lake Dr
Columbia, MO 65203-7172
Phone (417) 234-2860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Big Tree Medical Group LLC CurrentSince May 23, 2021 Accepting new patients
Little Tree Pediatric Urgent Care LLC Pediatrics Current Accepting new patients

Locations

200 Corporate Lake Dr
Columbia, MO 65203
Phone (417) 234-2860

206 Corporate Lake Dr
Columbia, MO 65203
Phone (573) 814-1170

2410 S Limit Ave
Sedalia, MO 65301
Phone (573) 814-1170

Interoperability endpoints

  • Direct secure messaging: adam.wheeler@115443077021700.direct.elationemr.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1891803086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE LAKE DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652037172",
            "telephone_number": "573-814-1170",
            "fax_number": "573-530-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CORPORATE LAKE DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652037172",
            "telephone_number": "573-814-1170",
            "fax_number": "573-530-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "ADAM",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2009003448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.