Mary Kathryn Wiedenhoeft, OM LAC NCCDOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AP1975 Issued in FL

Practice address

17130 Royal Palm Blvd
Suite 2
Weston, FL 33326

Phone

(954) 389-8404

Fax

(954) 389-8404

NPI assigned

Oct 23, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255414579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12717 NW 11TH COURT",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "33323",
            "telephone_number": "954-328-2964",
            "fax_number": "954-389-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17130 ROYAL PALM BLVD",
            "address_2": "SUITE 2",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "33326",
            "telephone_number": "954-389-8404",
            "fax_number": "954-389-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDENHOEFT",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "OM LAC NCCDOM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP1975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stuart H Whiteman, R.PH.
• Whole Mind of Florida PA
• Nordia Whyte, PA
• Cristina Alexandra Wiborg, SLP
• Monica Wickham
• Darice T Wiegel, DO
• Kathleen Marie Wiernicki
• Adrianna Alicja Wierzbicka, MD
• Gregg Orin Wilentz, DO
• Brandon Michael Wilkinson, MD

• Acupuncturist in Weston, FL
• Providers in Weston, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.