John Easter Wimmer, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

25465 Issued in NC

Practice address

628 Green Valley Rd
Suite 210
Greensboro, NC 27408-7730

Phone

(336) 478-1016

Fax

(336) 851-1737

NPI assigned

Jun 15, 2006

Last updated

Dec 14, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

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 Medicine

State licenses

Practice roles

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.

• Piedmont Neonatology PC

  • Neonatal-Perinatal Medicine Physician
  • Greensboro, NC
  • NPI 1386827335
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1972547305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 GREEN VALLEY RD",
            "address_2": "SUITE 210",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087730",
            "telephone_number": "336-478-1016",
            "fax_number": "336-851-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 GREEN VALLEY RD",
            "address_2": "SUITE 210",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087730",
            "telephone_number": "336-478-1016",
            "fax_number": "336-851-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMMER",
        "first_name": "JOHN",
        "middle_name": "EASTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "25465",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NC",
            "license": "25465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "C5375",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "88511",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8988511",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5150034",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasha Wilson, RN
• Tasha Danielle Wilson, LPC
• Taylor Wilson, AUD
• Tiffany A Wilson, MS, LPCA, NCC
• Tykiesha McDaniel Wilson, FNP
• Imani Winchester
• Iona Willett Windsor
• Rebecca Moser Windsor, PT
• Catherine Riley Wineburg, MSW
• Marjorie Wingate, RPH

• Neonatal-Perinatal Medicine Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Neonatal-Perinatal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.