Cardinal Elements Inc

Primary specialty

Community Health/Public Health Clinical Nurse SpecialistTaxonomy code 364SC1501X

License

28088637A Issued in IN

Legal business name

CARDINAL ELEMENTS INC

Practice address

4108 W 400 S
New Palestine, IN 46163-9612

Phone

(317) 410-9140

NPI assigned

Aug 2, 2014

Organization subpart

No

Name

Mary Ann Wietbrock, RN MSN CNSNPI 1336551175

Title

Clinical Nurse Specialist

Phone

(317) 410-9140

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Ann Wietbrock, RN MSN ACNS-BC

  • Clinical Nurse Specialist
  • Cumberland, IN
  • NPI 1336551175

  IN, Multi-Specialty

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in IN

Locations

• Mary Ann Wietbrock, CNS Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 26, 2014.

{
    "created_epoch": "1406937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409011200000",
    "number": "1659780708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 W 400 S",
            "city": "NEW PALESTINE",
            "state": "IN",
            "postal_code": "461639612",
            "telephone_number": "317-410-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 W 400 S",
            "city": "NEW PALESTINE",
            "state": "IN",
            "postal_code": "461639612",
            "telephone_number": "317-410-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL ELEMENTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-02",
        "last_updated": "2014-08-26",
        "status": "A",
        "authorized_official_last_name": "WIETBROCK",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "CLINICAL NURSE SPECIALIST",
        "authorized_official_telephone_number": "317-410-9140",
        "authorized_official_credential": "RN MSN CNS"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "IN",
            "license": "28088637A",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": "IN",
            "license": "28088637A",
            "primary": false
        },
        {
            "code": "364SC1501X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Community Health/Public Health",
            "state": "IN",
            "license": "28088637A",
            "primary": true
        },
        {
            "code": "364SC2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Chronic Care",
            "state": "IN",
            "license": "28088637A",
            "primary": false
        },
        {
            "code": "364SH0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "IN",
            "license": "28088637A",
            "primary": false
        },
        {
            "code": "364SH1100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Holistic",
            "state": "IN",
            "license": "28088637A",
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "IN",
            "license": "28088637A",
            "primary": false
        },
        {
            "code": "364SS0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, School",
            "state": "IN",
            "license": "28088637A",
            "primary": false
        },
        {
            "code": "364SX0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Occupational Health",
            "state": "IN",
            "license": "28088637A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Ann Wietbrock, CNS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in New Palestine, IN
• Community Health/Public Health Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.