Individual provider Active NPI

Frederick Wieden III

  • Physical Rehabilitation Occupational Therapist
  • Farmington, NM
National Provider Identifier
1700780343
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
Practice address
525 S Schwartz Ave
Farmington, NM 87401-5955
Phone
(505) 609-2625
NPI assigned
Oct 6, 2026
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X NU Primary

Addresses

Primary practice location

525 S Schwartz Ave
Farmington, NM 87401-5955

Mailing address

PO Box 869
Morro Bay, CA 93443-0869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1700780343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 869",
            "city": "MORRO BAY",
            "state": "CA",
            "postal_code": "934430869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S SCHWARTZ AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015955",
            "telephone_number": "505-609-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEN",
        "first_name": "FREDERICK",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.