Kelly Ann Wiese

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

Practice address

41155 Pond View Dr
Sterling Heights, MI 48314-3891

Phone

(586) 571-9626

NPI assigned

Jul 20, 2020

Sex

Female

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

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Weston Group Inc

  • Physical Therapist
  • Sterling Heights, MI
  • NPI 1578672762
  Medicare reassignment Care Compare group NPD
• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Superior Township, MI
  • NPI 1740840602
  Medicare reassignment NPD
• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1336808146
  NPD
• The Weston Group Inc.

  • Physical Therapist
  • Easton, PA
  • NPI 1750250759
  NPD

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728172800000",
    "number": "1053929638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD STE 205",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41155 POND VIEW DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143891",
            "telephone_number": "586-571-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2024-10-06",
        "certification_date": "2024-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teara White
• Brendon Whitney, LLPC
• Ivanna Wiczuk, LMT
• Alicia A Width, MA, PSYD
• Martha Wiebe
• Chrystal I Wilchcombe
• Alaya Chere Wiley
• Tara Wilford, LMSW
• Amber Willard
• William Beauont Hospital

• Gerontology Occupational Therapist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Gerontology Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.