Active NPI
Gerald Vincent Wiest, D.O.
- Family Medicine Physician
- Kirtland Air Force Base, NM
National Provider Identifier
1306825047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D. O. 716
- Practice address
- HQ Afia 9700 G Ave.SE
BLDG. 24499
Kirtland Air Force Base, NM 87117-5522 - Phone
- (508) 246-2486
- NPI assigned
- Jan 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D. O. 716 | NV | Primary |
Addresses
Primary practice location
HQ Afia 9700 G Ave.SE
BLDG. 24499
Kirtland Air Force Base, NM 87117-5522
Mailing address
HQ Afia
9700 G Ave SE, BLDG 24499
Kirtland Air Force Base, NM 87117-5522
Phone (702) 540-5808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D. O. 716 | NV | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340323200000",
"number": "1306825047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HQ AFIA",
"address_2": "9700 G AVE SE, BLDG 24499",
"city": "KIRTLAND AIR FORCE BASE",
"state": "NM",
"postal_code": "871175522",
"telephone_number": "702-540-5808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HQ AFIA 9700 G AVE.SE",
"address_2": "BLDG. 24499",
"city": "KIRTLAND AIR FORCE BASE",
"state": "NM",
"postal_code": "871175522",
"telephone_number": "508-246-2486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEST",
"first_name": "GERALD",
"middle_name": "VINCENT",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-11",
"last_updated": "2012-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "D. O. 716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirtland Air Force Base, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.