Active NPI
Timothy B Wiens, MD
- Family Medicine Physician
- Newton, KS
National Provider Identifier
1124037395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21488
- Practice address
- 720 Medical Center Dr
Newton, KS 67114-8778 - Phone
- (316) 283-6103
- Fax
- (316) 283-1333
- NPI assigned
- Aug 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21488 | KS | Primary |
Addresses
Primary practice location
720 Medical Center Dr
Newton, KS 67114-8778
Mailing address
720 Medical Center Dr
Newton, KS 67114-8778
Phone (316) 284-5170
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100115410B | Medicaid | KS | |
| 16875 | Other | KS | COVENTRY |
| 100408 | Other | KS | HPK |
| 024974 | Other | KS | BCBS |
| 1017 | Other | KS | PHS |
| 12149419 | Other | KS | MULTIPLAN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21488 | KS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1124037395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 MEDICAL CENTER DR",
"city": "NEWTON",
"state": "KS",
"postal_code": "671148778",
"telephone_number": "316-284-5170",
"fax_number": "316-283-1333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 MEDICAL CENTER DR",
"city": "NEWTON",
"state": "KS",
"postal_code": "671148778",
"telephone_number": "316-283-6103",
"fax_number": "316-283-1333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIENS",
"first_name": "TIMOTHY",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-06",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "21488",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100115410B",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "16875",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPK",
"identifier": "100408",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "024974",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS",
"identifier": "1017",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "12149419",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.