Nicolas A. Wieder, DO

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

075400 Issued in GA

Practice address

750 Townpark Lane
Kaiser Permanente Townpark Medical Center
Kennesaw, GA 30144

Phone

(818) 375-2000

NPI assigned

Jan 8, 2007

Sex

Male

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

Enrolled in GA, AK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pain ManagementAlso: Neurology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

NeuroversionGroup PAC ID 7012297062, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.68 of 100Reported as group

Quality

82.26

Promoting interoperability

99

Improvement activities

40

Cost

76.32

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Neuroversion

  • Interventional Pain Medicine Physician
  • Anchorage, AK
  • NPI 1487102208
  Medicare reassignment Care Compare group NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1467500322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-504-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 TOWNPARK LANE",
            "address_2": "KAISER PERMANENTE TOWNPARK MEDICAL CENTER",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30144",
            "telephone_number": "818-375-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDER",
        "first_name": "NICOLAS",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "20A5558",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "075400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Najah Whitfield, PHARMD, RPH
• Gwen Hatley Whiting, APRN MS BC
• Daniel Whitner
• Whittle Chiropractic Ctr., Inc. (The Wellpath Center)
• Elaine Atkins Whitworth, LMSW,LPC
• Tanya S Wilcox, NP
• Kendall E Wilde, DPT
• Raymon Joel Wilensky, M.D.
• Lesley Orman Wilkerson, MD
• Janna Williams-Pitts, PHD

• Pain Medicine Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.