David Lynn Wigginton Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2016013997 Issued in MO

Practice address

3105 McClelland Blvd.
Joplin, MO 64804

Phone

(417) 347-5400

Fax

(417) 347-5709

NPI assigned

Feb 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1036.epichosted.com/APIProxyPRD/AC/api/FHIR/R4

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.

• Arkansas Childrens Hospital

  dba ACH Physicians Billing Group

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1598773079
  Medicare reassignment NPD
• Northwest Benton County Physician Services LLC

  • Family Medicine Physician
  • Bentonville, AR
  • NPI 1871553073
  Medicare reassignment
• Northwest Physicians LLC

  • Obstetrics Physician
  • Springdale, AR
  • NPI 1194768721
  Medicare reassignment
• Siloam Springs Clinic Company LLC

  • Internal Medicine Physician
  • Siloam Springs, AR
  • NPI 1013155431
  Medicare reassignment
• University of Arkansas for Medical Sciences

  dba Childrens University Medical Group

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1346230968
  Medicare reassignment
• Northwest Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Springdale, AR
  • NPI 1205137536
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  dba FGP Managed Care

  • General Practice Physician
  • Little Rock, AR
  • NPI 1326341488
  NPD
• Arkansas Childrens Hospital

  • Dental Clinic/Center
  • Little Rock, AR
  • NPI 1770889552
  NPD (past)
• Arkansas Childrens Northwest, Inc.

  • Children's Hospital
  • Springdale, AR
  • NPI 1255875746
  NPD (past)
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  NPD (past)

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1912247156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-778-8522",
            "fax_number": "615-628-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 MCCLELLAND BLVD.",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-347-5400",
            "fax_number": "417-347-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINTON",
        "first_name": "DAVID",
        "middle_name": "LYNN",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-26",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2016013997",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22840",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA22840",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "PA22840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whole Heart LLC
• Luke Monell Wicke, DO
• Tammy Marie Wicke, DO
• Emily Wickstrom, MSW, LMSW
• Amy Lynn Wiegers, M.S., CCC-SLP
• Justin D Wilberding, D.O.
• Kirby Michael Wilcox
• Keaton Wilczynski
• Matthew Steven Wilkes, NP
• Wilkinson Pharmacy Inc (Wilkinson Pharmacy 9)

• Physician Assistant in Joplin, MO
• Providers in Joplin, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.