Kelly Baker Wiese, MSW, MPH, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

52511 Issued in TX

Practice address

9416 Gardenia Bend Dr
San Antonio, TX 78266-2522

Phone

(210) 508-1769

NPI assigned

Apr 28, 2021

Last updated

Apr 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kellybakerwiese@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1699357608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9416 GARDENIA BEND DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782662522",
            "telephone_number": "210-508-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9416 GARDENIA BEND DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782662522",
            "telephone_number": "210-508-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER WIESE",
        "first_name": "KELLY",
        "credential": "MSW, MPH, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "52511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Momena Bajwa, MD
• Michelle I Baka, MD
• Nuray Bakal, MD
• Omer Bakal
• Oluwatosin Oluwafemi Bakare
• Abigail Baker
• Alisia Diane Baker, PHARM.D.
• Allyson L Baker, PSY.D.
• Andrew Martin Baker, DDS
• Beatrice Marie Baker, ATTENDANT PROVIDER

• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.