NPIMap

Organization Active NPI

Wieland Associates, Inc.

  • Psychologist
  • Fort Wayne, IN
National Provider Identifier
1356547962
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WIELAND ASSOCIATES, INC.
Practice address
1415 Magnavox Way
Ste: 120
Fort Wayne, IN 46804-1553
Phone
(260) 483-7207
Fax
(260) 483-0836
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Dr. Kevin Lee Wieland, PSY.D., HSPP
Title
President/Psychologist
Phone
(260) 483-7207

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X IN Primary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 20041419A IN

Addresses

Primary practice location

1415 Magnavox Way
Ste: 120
Fort Wayne, IN 46804-1553

Mailing address

1415 Magnavox Way
Ste:120
Fort Wayne, IN 46804-1553
Phone (260) 483-7207

Other identifiers 2

IdentifierTypeStateIssuer
200260310AMedicaidIN
200360310AMedicaidIN

National Provider Directory

National Provider Directory

Locations

1415 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 483-7207

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1356547962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 MAGNAVOX WAY",
            "address_2": "STE:120",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041553",
            "telephone_number": "260-483-7207",
            "fax_number": "260-483-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 MAGNAVOX WAY",
            "address_2": "STE: 120",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041553",
            "telephone_number": "260-483-7207",
            "fax_number": "260-483-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIELAND ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "WIELAND",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT/PSYCHOLOGIST",
        "authorized_official_telephone_number": "260-483-7207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., HSPP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041419A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200260310A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200360310A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.