Individual provider Active NPI

Mark C Wieland, DC

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1104826940
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0005183 Issued in FL
Practice address
510 Pasadena Ave S
St Petersburg, FL 33707-2126
Phone
(727) 343-3959
Fax
(727) 343-3125
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0005183 FL Primary

Addresses

Primary practice location

510 Pasadena Ave S
St Petersburg, FL 33707-2126

Mailing address

510 Pasadena Ave S
St Petersburg, FL 33707-2126
Phone (727) 343-3959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0005183FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Reinhardt Chiropractic, LLC Chiropractor CurrentSince May 14, 2018 Accepting new patients

Locations

510 Pasadena Ave S
St Petersburg, FL 33707
Phone (727) 341-1234

Interoperability endpoints

  • Direct secure messaging: mark.wieland.1@11209.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104826940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 PASADENA AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337072126",
            "telephone_number": "727-343-3959",
            "fax_number": "727-343-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 PASADENA AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337072126",
            "telephone_number": "727-343-3959",
            "fax_number": "727-343-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELAND",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0005183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.