Douglas K Wiesner, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

24-00151 Issued in KS

Practice address

10777 Nall Ave
Suite 320
Overland Park, KS 66211-1362

Phone

(913) 663-2555

Fax

(913) 312-1781

NPI assigned

Jun 4, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sports Rehab Physical & Hand Therapy

  • Physical Therapy Clinic/Center
  • Overland Park, KS
  • NPI 1275915365
  NPD (past)
• Sports Rehabilitation & Physical Therapy Associates Inc.

  • Physical Therapist
  • Overland Park, KS
  • NPI 1528018108

  Athletic Trainer

  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1710925136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 NALL AVE",
            "address_2": "SUITE 130",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111363",
            "telephone_number": "913-663-2555",
            "fax_number": "913-663-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE",
            "address_2": "SUITE 320",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111362",
            "telephone_number": "913-663-2555",
            "fax_number": "913-312-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESNER",
        "first_name": "DOUGLAS",
        "middle_name": "K",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven M. Wien, M.D.
• Bennye Kaye Wienecke
• Arthur S. Wientzen, M.D.
• Marlee Wier
• Brandon D Wiese, DC
• Patricia Marie Wietnik, PTA
• Amber Wiggans
• Jonathan Allen Wiggins, D.C.
• Lofton Cole Wiggs, CRNA
• Paige Wiggs

• Athletic Trainer in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Athletic Trainer in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.