Colleen R Wight, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4924 Issued in AZ

Practice address

2940 E Banner Gateway Dr
Ste 200
Gilbert, AZ 85234-2171

Phone

(480) 964-2908

Fax

(480) 833-2136

NPI assigned

Oct 12, 2006

Last updated

Jan 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1437248903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 W WARNER RD",
            "address_2": "STE 23",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241674",
            "telephone_number": "602-772-3800",
            "fax_number": "602-772-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 E BANNER GATEWAY DR",
            "address_2": "STE 200",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342171",
            "telephone_number": "480-964-2908",
            "fax_number": "480-833-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGHT",
        "first_name": "COLLEEN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13596",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Wielinski
• Julia Elizabeth Wiens, LMSW
• Sierra C Wiese, SLPA
• Ariel Kaye Wiesner, SLPA
• Cheryl A Wieweck, NNP
• Kati Wijdenes, DNP
• Eliza Evelyn Wilbur, MS, CCC-SLP
• Gina Del Wilcken, COTA/L
• Grace Wilcock, LPN, CLC
• Carson Reed Wilde, DC

• Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.