NPIMap

Organization Active NPI

David a. Wiersema, D.O., PLLC

  • Physical Medicine & Rehabilitation Physician
  • Saginaw, MI
National Provider Identifier
1154572972
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
DAVID A. WIERSEMA, D.O., PLLC
Practice address
4701 Towne Ctr
Ste. 102
Saginaw, MI 48604-2834
Phone
(989) 797-4610
Fax
(989) 797-4612
NPI assigned
Oct 10, 2008
Last updated
Nov 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Authorized official

Name
Dr. David A Wiersema, DONPI 1851322549
Title
President
Phone
(989) 797-4610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

4701 Towne Ctr
Ste. 102
Saginaw, MI 48604-2834

Mailing address

4701 Towne Ctr
Ste. 102
Saginaw, MI 48604-2834
Phone (989) 797-4610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081124000678 MI Part B Supplier - Clinic/Group Practice 5496815284 Receives reassigned benefits from 1 practitioner
Practice locations: Bay City, MI; Caro, MI; Kingsley, MI; Saginaw, MI

National Provider Directory

National Provider Directory

Locations

3707 Katalin Ct
Bay City, MI 48706
Phone (989) 671-0866

4160 Beacon St
Kingsley, MI 49649
Phone (231) 263-1350

4701 Towne Centre Rd
Ste 1
Saginaw, MI 48604
Phone (989) 793-4747

4701 Towne Centre Rd
Ste 102
Saginaw, MI 48604
Phone (989) 797-4610

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227571200000",
    "number": "1154572972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 TOWNE CTR",
            "address_2": "STE. 102",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042834",
            "telephone_number": "989-797-4610",
            "fax_number": "989-797-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 TOWNE CTR",
            "address_2": "STE. 102",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042834",
            "telephone_number": "989-797-4610",
            "fax_number": "989-797-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A. WIERSEMA, D.O., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2008-11-25",
        "status": "A",
        "authorized_official_last_name": "WIERSEMA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-797-4610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.