Provider Demographics
NPI:1730177627
Name:WHELLER, JOHN JAMES (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JAMES
Last Name:WHELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CHILDREN'S DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-3100
Mailing Address - Fax:614-722-2549
Practice Address - Street 1:700 CHILDREN'S DRIVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-3100
Practice Address - Fax:614-722-2549
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350486712080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0562805Medicaid
KY64789456OtherMEDICAID
WV0105644000OtherMEDICAID
KY64789456OtherMEDICAID
OHWH0580902OtherMEDICARE
A16370Medicare UPIN