Russell Duane Wiesley, RPH, CDM

Primary specialty

PharmacistTaxonomy code 183500000X

License

14611 Issued in IA

Practice address

4343 Merle Hay Rd
Des Moines, IA 50310-1411

Phone

(515) 276-4845

Fax

(515) 331-3163

NPI assigned

May 24, 2005

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1295738102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 WALNUT RIDGE DR",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502639619",
            "telephone_number": "515-224-0227",
            "fax_number": "515-222-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 MERLE HAY RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503101411",
            "telephone_number": "515-276-4845",
            "fax_number": "515-331-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESLEY",
        "first_name": "RUSSELL",
        "middle_name": "DUANE",
        "credential": "RPH, CDM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "14611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007559",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Charles Wickard, MD
• William J Wickemeyer, M.D.
• Dustin O Wiemers, MD
• Taylor Wiese
• Bernard Wiesemann, LISW
• Lucy Wiggins, TLMHC, CADC
• Bradley E Wilcox, DO
• Gabriel Wilk, REGISTERED NURSE
• Steve Charles Wilkens, PHARM D, BCPS
• Duane Verne Wilkins, MD

• Pharmacist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Pharmacist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.