Individual provider Active NPI

Stephen Henry Wolken, M.D.

  • Ophthalmology Physician
  • Iowa City, IA
National Provider Identifier
1962409623
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
18039 Issued in IA
Practice address
540 E Jefferson St
Suite 201
Iowa City, IA 52245-2477
Phone
(319) 338-3623
Fax
(319) 338-7289
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 18039 IA Primary

Addresses

Primary practice location

540 E Jefferson St
Suite 201
Iowa City, IA 52245-2477

Mailing address

540 E Jefferson St
Suite 201
Iowa City, IA 52245-2477
Phone (319) 338-3623

Other identifiers 3

IdentifierTypeStateIssuer
180022815OtherIARAILROAD MEDICARE
0039792MedicaidIA
42144513504OtherIAJOHN DEERE HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18039IAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1962409623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 E JEFFERSON ST",
            "address_2": "SUITE 201",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452477",
            "telephone_number": "319-338-3623",
            "fax_number": "319-338-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E JEFFERSON ST",
            "address_2": "SUITE 201",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452477",
            "telephone_number": "319-338-3623",
            "fax_number": "319-338-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLKEN",
        "first_name": "STEPHEN",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "18039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180022815",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0039792",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH",
            "identifier": "42144513504",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.