Tara Wiesner, MSN,CCM

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

0140447 Issued in CO

Practice address

12337 Jones Rd Ste 100
Houston, TX 77070-4844

Phone

(303) 570-0134

Fax

(877) 747-9662

NPI assigned

Oct 4, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1728000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1245059450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1852 PARKDALE CIR S",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805162407",
            "telephone_number": "720-933-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12337 JONES RD STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704844",
            "telephone_number": "303-570-0134",
            "fax_number": "877-747-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESNER",
        "first_name": "TARA",
        "credential": "MSN,CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CO",
            "license": "0140447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Carl Wiener, M.D.
• Kristin Wiercinski
• William G. Wierda, M.D., PHD
• Andrew David Wiese, PHD
• Scott Thomas Wiesenborn, M.D.
• Wigberto Soto M.D.P.a.
• Wigberto Soto, M.D. P.a.
• Matthew Wigder, MD
• Wiggins & Shoaf Investments LLC
• Wiggins Enterprise LLC

• Case Management Registered Nurse in Houston, TX
• Providers in Houston, TX by specialty
• Case Management Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.