Jeanette Wieske

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501005427 Issued in MI

Practice address

27240 Haggerty Rd
Suite E15
Farmington Hills, MI 48331-5716

Phone

(866) 991-0900

NPI assigned

Aug 26, 2014

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

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

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.

• Behavioral Outcomes Management,LLC

  • Community/Behavioral Health Agency
  • Troy, MI
  • NPI 1184139131

  Physical Therapist

  Medicare reassignment NPD
• Part B LLC

  • Physical Therapist
  • Troy, MI
  • NPI 1285395962
  NPD (past)

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1164822276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23771 RAVEN AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213405",
            "telephone_number": "866-991-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27240 HAGGERTY RD",
            "address_2": "SUITE E15",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483315716",
            "telephone_number": "866-991-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESKE",
        "first_name": "JEANETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Wiegers
• Sherralle Wieglenda
• Alexis Wierenga
• Elliot Wierenga
• Keri Wiesen Vansumeren
• Haley Wiewiora
• Britney Wiggins-Lopez
• Ajanique Wiggins
• Brianna Wiggins
• Michaela D Wiggins

• Physical Therapist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.