Kenneth E Wiemar, M. D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

12545 Issued in OK

Practice address

1919 S Wheeling Ave
Suite 300
Tulsa, OK 74104-5638

Phone

(918) 748-7570

Fax

(918) 748-7573

NPI assigned

Mar 23, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kenneth.wiemar@direct.stjohnhealthsystem.com

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1194785303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-748-7570",
            "fax_number": "918-748-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-748-7570",
            "fax_number": "918-748-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMAR",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "12545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "731346102",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100162400A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Dawn Wickson
• Spencer David Wideman
• Christopher Widmar
• Rachel Lynn Wiedeman, MA
• Lisa Wiedenhaupt
• Suzanne Hurd Wiemar
• Victoria Farm Wiener
• Cydney Wiens, PA-C
• Ethan Wiens
• Jeffery M Wiens

• Specialist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.