Jeanie Marie Wiertzema, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3945 Issued in AR

Practice address

5206 W Village Pkwy Ste 6
Rogers, AR 72758-8137

Phone

(479) 936-2978

NPI assigned

Dec 30, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mercy Hospital Rogers

  • Home Health Agency
  • Rogers, AR
  • NPI 1942265160
  NPD
• Mercy Hospital Rogers

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  NPD (past)

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1124836663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16025 HICKORY DR",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727566358",
            "telephone_number": "417-844-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5206 W VILLAGE PKWY STE 6",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588137",
            "telephone_number": "479-936-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERTZEMA",
        "first_name": "JEANIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT3945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinity Talyn White
• Melissa Lee Whiting
• Lighla Whitson, M.S., CF-SLP
• Michelle Cherie Wieneke, APRN
• Bradley Wierda, CRNA
• Angela Wieser
• Shelby Wigginton
• William C. Wigington, D.O.
• Catherine Lynnette Wikoff, MD
• Wild Fig, PLLC

• All providers in Rogers, AR
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.