Collier S Wiese, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601002503 Issued in MI

Practice address

1541 Gull Rd
Suite 200
Kalamazoo, MI 49048-1639

Phone

(269) 343-1264

Fax

(269) 343-9555

NPI assigned

Jan 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1003896382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 GULL RD",
            "address_2": "SUITE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481639",
            "telephone_number": "269-343-1264",
            "fax_number": "269-343-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 GULL RD",
            "address_2": "SUITE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481639",
            "telephone_number": "269-343-1264",
            "fax_number": "269-343-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "COLLIER",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Iris Wieleba
• Christopher Wienczewski, MD
• Robert William Wierenga, MD
• Jason Tyler Wiersema, D.P.T.
• Sheryl Wiescholek, RN
• Gregory Charles Wiggins, M.D.
• Kristen Barrett Wight, PA-C
• Lauren Adele Wight, PA-C
• Patricia S. Wiita, NP
• Verle Howard Wiita, DDS

• Physician Assistant in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.