Jordan Wiebe, DO

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

012361 Issued in AZ

Practice address

2801 E Camelback Rd
Ste 100
Phoenix, AZ 85016-4363

Phone

(480) 680-9903

NPI assigned

Apr 18, 2019

Last updated

Aug 20, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwiebe724253@direct.ynhh.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yale University

  dba Yale Medicine

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1215590831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 E CAMELBACK RD",
            "address_2": "STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164363",
            "telephone_number": "480-680-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 E CAMELBACK RD",
            "address_2": "STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164363",
            "telephone_number": "480-680-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBE",
        "first_name": "JORDAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CT",
            "license": "80521",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "012361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Scott Widmaier, DC
• Courtney Widmer
• Michael Blaine Widmer, DO
• Dayna Alison Widoff, M.S.
• Christopher Sung Wie, MD
• Robert J Wiebers, APN
• Tana Wiebers
• Jeanne Ray Wiedemann, NNP-BC
• Nicholas Ryan Wieferich, PHARMD
• Aaron Lawrence Wiegand, D.C.

• Plastic and Reconstructive Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Plastic and Reconstructive Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.