Kenneth Niel Wiesert, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01026404A Issued in IN

Practice address

5868 E 71St St
#123
Indianapolis, IN 46220-4002

Phone

(317) 885-2334

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• K Donald Shelbourne MD LLC

  dba Shelbourne Knee Center at Methodist Hospital

  • Orthopedic Physical Therapist
  • Indianapolis, IN
  • NPI 1538166988
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1538110101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 RADNOR RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462262150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5868 E 71ST ST",
            "address_2": "#123",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204002",
            "telephone_number": "317-885-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESERT",
        "first_name": "KENNETH",
        "middle_name": "NIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01026404A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100189000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Wiemann, MD
• David Wiener, DDS
• Andrea L Wiens, D.O.
• Margarita Arkadiy Wiersema, M.D.
• Pieter Wiersema, MD
• Tina Suzanne Wiesert
• Peter L Wiethe, MA, LMHC
• Jay Foster Wigboldy, MD
• Wigeon Emergency Physicians LLC
• Aretha Wiggins

• Psychiatry Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.