Individual provider Active NPI

John M Wegner, P.A.-C

  • Physician Assistant
  • Alma, MI
National Provider Identifier
1003892696
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002998 Issued in MI
Practice address
300 E Warwick Dr
Alma, MI 48801-1014
Phone
(989) 466-3228
NPI assigned
Dec 16, 2005
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002998 MI Primary

Addresses

Primary practice location

300 E Warwick Dr
Alma, MI 48801-1014

Mailing address

1225 Abbey LN
Mt Pleasant, MI 48858-9137
Phone (989) 317-0335

Other identifiers 1

IdentifierTypeStateIssuer
0153701280OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20040717000035 MI Practitioner - Physician Assistant 9830178367 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601002998MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince Oct 15, 2018 Accepting new patients
Sparrow Clinton Hospital CurrentSince Jan 30, 2024 Accepting new patients
Sparrow Carson Hospital CurrentSince Oct 15, 2018 Accepting new patients
Michigan Emergency Physicians LLP Physician Assistant CurrentSince May 1, 2009 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

102 S 3rd St
Ste 100
Carson City, MI 48811
Phone (989) 584-1308

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

703 N McEwan St
Clare, MI 48617
Phone (989) 802-5000

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1003892696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 ABBEY LN",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488589137",
            "telephone_number": "989-317-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E WARWICK DR",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488011014",
            "telephone_number": "989-466-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGNER",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0153701280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alma, MI

Sources for this page

Verify at the official NPI Registry.