Bradley David Wiest

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4079 Issued in NC

Practice address

8912 Blakeney Professional Dr
Suite 100
Charlotte, NC 28277-6660

Phone

(704) 544-5353

NPI assigned

Apr 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

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.

• Carolina Sports Clinic-Fort Mill,LLC

  • Chiropractor
  • Fort Mill, SC
  • NPI 1144605759
  Medicare reassignment NPD
• Momentum Sport & Spine, PC

  • Health Service Clinic/Center
  • Fort Mill, SC
  • NPI 1215824982
  NPD Authorized official
• Carolina Sports Chiropractic PLLC

  • Chiropractor
  • Charlotte, NC
  • NPI 1902034846
  Medicare reassignment
• Fort Mill Spine and Sports Rehab, LLC

  • Chiropractor
  • Fort Mill, SC
  • NPI 1386434074
  NPD (past)

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1629395017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 ARBORHILL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8912 BLAKENEY PROFESSIONAL DR",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776660",
            "telephone_number": "704-544-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEST",
        "first_name": "BRADLEY",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean L Wiegand, CRNA
• Craig Wiehe Jr., DPT
• Cindy E Wiener, DC
• David R Wiercisiewski, MD
• Doris Elisabeth Wiese, PT
• Alexandria Elizabeth Wiezbiski, M.S., CCC-SLP
• Wig Out LLC
• Meeta Wig, M.D.
• Lisa Wigfall, LCASA
• Adrienne Elizabeth Wiggins-Metcalf, MD

• Chiropractor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.