Walter Wielkiewicz, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35052245W Issued in OH

Practice address

751 Forest Ave Ste 402
Zanesville, OH 43701-2878

Phone

(740) 454-0196

NPI assigned

Dec 14, 2005

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

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1063497824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 BETHESDA DR",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011800",
            "telephone_number": "740-454-4651",
            "fax_number": "740-454-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE STE 402",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012878",
            "telephone_number": "740-454-0196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2945 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "437011753",
            "country_code": "US",
            "telephone_number": "740-454-0196",
            "fax_number": "740-454-7834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIELKIEWICZ",
        "first_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35052245W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE PIN",
            "identifier": "311413469055",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PIN",
            "identifier": "0101533",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0596789",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON PIN",
            "identifier": "000000177605",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "0989499",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE RAILROAD",
            "identifier": "CA1586",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000019630",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080019531",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Ann White, LPN
• Raya White, DNP, APRN, PMHNP BC
• Junior Eli Whitlatch, BA, QMHS
• Whitney McLain
• Christi L Wicker, LPN
• Wild Ohio Therapy Farm
• Michael Allen Wildroudt II
• Robin Nicole Wiley, LPN
• Alexis Jordan Wilkins, PHARMD
• Carl Clayton Wilkins, ATC

• Family Medicine Physician in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.