Individual provider Active NPI

Kali Brianne Wieland, FNP-C

  • Family Nurse Practitioner
  • Boerne, TX
National Provider Identifier
1083375166
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1056581 Issued in TX
Practice address
25723 Old Fredericksburg Rd
Boerne, TX 78015-6605
Phone
(210) 450-6810
Fax
(210) 450-6023
NPI assigned
Jan 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1056581 TX Primary

Addresses

Primary practice location

25723 Old Fredericksburg Rd
Boerne, TX 78015-6605

Mailing address

25723 Old Fredericksburg Rd
Boerne, TX 78015-6605
Phone (210) 450-6810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220905000400 TX Practitioner - Nurse Practitioner 5496139727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

25723 Old Fredericksburg Rd
Boerne, TX 78015-6605
Phone (210) 450-9000

Hospital & facility affiliations

  • Beyondfaith Homecare & Rehab San Antonio Home health agency, San Antonio, TX, CCN 747518
  • Ut Health San Antonio Multispecialty & Research Ho Hospital, San Antonio, TX, CCN 670335
  • Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Jun 17, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jun 17, 2022 Accepting new patients

Locations

25723 Old Fredericksburg Rd
Boerne, TX 78015
Phone (210) 450-6800

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

Interoperability endpoints

  • Direct secure messaging: kwieland35348@direct.utmsa.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1640995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1083375166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25723 OLD FREDERICKSBURG RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780156605",
            "telephone_number": "210-450-6810",
            "fax_number": "210-450-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25723 OLD FREDERICKSBURG RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780156605",
            "telephone_number": "210-450-6810",
            "fax_number": "210-450-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELAND",
        "first_name": "KALI",
        "middle_name": "BRIANNE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-01",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1056581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.