Individual provider Active NPI

Robert D Wiele, MD

  • Emergency Medicine Physician
  • O Fallon, MO
National Provider Identifier
1356449771
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R9840 Issued in MO
Practice address
2 Progress Point CT
Progress West Health Center
O Fallon, MO 63368-2208
Phone
(314) 740-6471
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R9840 MO Primary

Addresses

Primary practice location

2 Progress Point CT
Progress West Health Center
O Fallon, MO 63368-2208

Mailing address

5 Garden LN
Kirkwood, MO 63122-2636
Phone (314) 821-6471

Other identifiers 1

IdentifierTypeStateIssuer
201593613MedicaidMO

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R9840MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BC Progress Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
SSM Health Care St. Louis Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1356449771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GARDEN LN",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631222636",
            "telephone_number": "314-821-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PROGRESS POINT CT",
            "address_2": "PROGRESS WEST HEALTH CENTER",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682208",
            "telephone_number": "314-740-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELE",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R9840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201593613",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.