JOHN DAVID WILSON MD
NPI 1235138801
Pediatrics in Ottumwa, IA

NPI Status: Active since July 18, 2005

Contact Information

931 PENNSYLVANIA AVE
OTTUMWA PEDIATRICS
OTTUMWA, IA
ZIP 52501
Phone: (641) 684-3000
Fax: (641) 684-2469

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  • Individual
  • Male
  • Pediatrics
  • Accepts Insurance
  • PECOS Enrolled

About JOHN WILSON

This page provides the complete NPI Profile along with additional information for John Wilson, a pediatrician established in Ottumwa, Iowa with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1235138801 assigned on July 2005. The practitioner's primary taxonomy code is 208000000X with license number 36914 (IA). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1235138801
Provider Name
JOHN DAVID WILSON MD
Gender
Male
Entity Type
Individual
Location Address
931 PENNSYLVANIA AVE OTTUMWA PEDIATRICS OTTUMWA, IA 52501
Location Phone
(641) 684-3000
Location Fax
(641) 684-2469
Mailing Address
312 E ALTA VISTA ORHC CLINICS OTTUMWA, IA 52501
Mailing Phone
(641) 684-3000
Mailing Fax
(641) 684-2469
Is Sole Proprietor?
No
Enumeration Date
07-18-2005
Last Update Date
10-24-2007
Code Navigator

A pediatrician like John Wilson is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
License No.
36914
License State
IA
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Clear Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO
  • Medica Insure Expanded Bronze Standard - EPO
  • Medica Insure Gold $0 Copay PCP Visits - EPO
  • Medica Insure Gold Share - EPO
  • Medica Insure Gold Standard - EPO
  • Medica Insure Silver $0 Copay PCP Visits - EPO
  • Medica Insure Silver Share - EPO
  • Medica Insure Silver Standard - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
28375OTHER (01)IABCBS OF IA
F86973MEDICARE UPIN (02)IA 
0746719MEDICAID (05)IA 
JA0171OTHER (01)IAJOHN DEERE HEALTH
010784T76MEDICARE ID-TYPE UNSPECIFIED (04)DE 
0000576001MEDICAID (05)DE 

Medicare Participation & PECOS Enrollment Status

John Wilson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 52501 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.84
  • Minimum New Patient Price $52.96
  • Maximum New Patient Price $161.4
  • Average New Patient Copayment $20.46
  • Minimum New Patient Copayment $13.24
  • Maximum New Patient Copayment $40.35

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.05
  • Minimum Established Patient Price $16.91
  • Maximum Established Patient Price $131.98
  • Average Established Patient Copayment $23.51
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for JOHN DAVID WILSON MD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1235138801, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
3
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
8
Unchanged
Pos 9
0
Doubled → 0
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 1 → 2 8 → 16 → 7 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 6 + 5 + 2 + 3 + 1 + 6 + 8 + 0 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1235138801.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Nurse Practitioner (Pediatrics)
931 PENNSYLVANIA AVE
OTTUMWA, IA 52501
Pediatrics
931 PENNSYLVANIA AVE
OTTUMWA, IA 52501
Advanced Practice Midwife
931 PENNSYLVANIA AVE
OTTUMWA, IA 52501
Clinic/Center (Rural Health)
931 PENNSYLVANIA AVE
OTTUMWA, IA 52501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235138801, enumerated as an "individual" on July 18, 2005.

The provider is located at 931 PENNSYLVANIA AVE OTTUMWA PEDIATRICS OTTUMWA, IA 52501 and the phone number is (641) 684-3000.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from NH. Please consult your insurance carrier or call the provider to verify.