Individual provider Active NPI

Makenze Taylor Wieneke, NP

  • Family Nurse Practitioner
  • Seymour, IN
National Provider Identifier
1649014416
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015837A Issued in IN
Practice address
411 W Tipton St
Seymour, IN 47274-2363
Phone
(812) 523-5862
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71015837A IN Primary

Addresses

Primary practice location

411 W Tipton St
Seymour, IN 47274-2363

Mailing address

411 W Tipton St
Seymour, IN 47274-2363
Phone (812) 523-5862

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016003101 IN Practitioner - Nurse Practitioner 5799217667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

411 W Tipton St
Schneck Medical Center
Seymour, IN 47274-2363
Phone (812) 522-2349

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71015837AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Schneck Memorial Hospital Family CurrentSince Sep 30, 2024 Accepting new patients
Seymour Indiana Pathologists, Inc Past Accepting new patients

Locations

1124 Medical Pl
Seymour, IN 47274
Phone (812) 519-1552

200 S Walnut St
Seymour, IN 47274
Phone (812) 522-2349

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1649014416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-523-5862",
            "fax_number": "812-523-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-523-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENEKE",
        "first_name": "MAKENZE",
        "middle_name": "TAYLOR",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015837A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

Verify at the official NPI Registry.