Dawn Wietfeldt, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4867 Issued in KY

Practice address

4123 Taylor Blvd
Louisville, KY 40215-2341

Phone

(502) 363-7172

Fax

(502) 363-7174

NPI assigned

Nov 21, 2006

Sex

Female

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

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Advanced Chiropractic of Midland P.C.

  dba Advanced Chiropractic

  • Chiropractor
  • Midland, MI
  • NPI 1821022070
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1235204744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 STONECREST COURT",
            "address_2": "SUITE 140",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "40065",
            "telephone_number": "502-647-4600",
            "fax_number": "502-647-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 TAYLOR BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402152341",
            "telephone_number": "502-363-7172",
            "fax_number": "502-363-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETFELDT",
        "first_name": "DAWN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7045635",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000349858",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryann Wiese, LPCC-S
• Tanya A Wiese, D.O.
• Cheryl Ann Wiesemann
• Richard J. Wiesemann, M.D.
• Chad A Wiesenauer, M.D.
• Gretchen Anne Wigand, DMD
• Kelsey Elaine Wigand
• Thomas Louis Wigger, DMD
• Thomas Stewart Wigger, DMD
• Andrea Wiggins Clark, DVM

• Chiropractor in Louisville, KY
• Providers in Louisville, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.