Matthew M Wienecke, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

14381 Issued in SC

Practice address

9 Richland Medical Park Dr
Suite 200a
Columbia, SC 29203-6859

Phone

(803) 434-7940

Fax

(803) 434-2262

NPI assigned

Jul 2, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1104855089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7303",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 200A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036859",
            "telephone_number": "803-434-7940",
            "fax_number": "803-434-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENECKE",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "SC",
            "license": "14381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143810",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colin English Widener, MD
• Michelle Widener, M.D.
• Rebecca W Widener, MD.
• Paul E Widmayer, MSRD
• Anna K Wiegner, FNP-BC
• Benjamin Thomas Wietecha, DMD
• Scott C Wietecha, DMD
• Billy W. Wiggins, RN
• Janelle Wiggins
• Karen Clarke Wiggins, RN

• Pediatric Cardiology Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatric Cardiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.