Active NPI
Fred Lee Wedeking, MD
- Emergency Medicine Physician
- Kalamazoo, MI
National Provider Identifier
1063847416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 4301026782
- Practice address
- 1034 Crown St
Kalamazoo, MI 49006-2102 - Phone
- (269) 381-3960
- Fax
- (269) 381-3960
- NPI assigned
- Sep 4, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4301026782 | MI | Primary |
Addresses
Primary practice location
1034 Crown St
Kalamazoo, MI 49006-2102
Mailing address
1034 Crown St
Kalamazoo, MI 49006-2102
Phone (269) 381-3960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 31, 2015 through Dec 31, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301026782 | MI | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1063847416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1034 CROWN ST",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490062102",
"telephone_number": "269-381-3960",
"fax_number": "269-381-3960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 CROWN ST",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490062102",
"telephone_number": "269-381-3960",
"fax_number": "269-381-3960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDEKING",
"first_name": "FRED",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-04",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "4301026782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.