Kimberly Sue Wiegand, CFM

Primary specialty

Orthotic FitterTaxonomy code 225000000X

License

CFM01697 Issued in IL

Practice address

2700 N Center St
Rte 159
Maryville, IL 62062-5624

Phone

(618) 288-7474

Fax

(618) 288-7037

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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.

• Maryville Pharmacy Inc

  • Pharmacist
  • Maryville, IL
  • NPI 1326082173
  NPD (past)

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1720230873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 N CENTER ST",
            "address_2": "RTE 159",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625624",
            "telephone_number": "618-288-7474",
            "fax_number": "618-288-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N CENTER ST",
            "address_2": "RTE 159",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625624",
            "telephone_number": "618-288-7474",
            "fax_number": "618-288-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGAND",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "CFM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "IL",
            "license": "049-177617",
            "primary": false
        },
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "IL",
            "license": "CFM01697",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "95212",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Werner, PA-C
• Alyssa Jordan Werths
• Eric L Wessel, PT
• Jennifer D Wesselman-Williams, NP
• Magen Seleste Westenberger, LCSW
• Sarah E Wiegman, PA-C
• Kylie Wielgopolan, OT, CHT
• Richard Henry Wikiera, D.O.
• Alisha Wilken, DPT
• Matthew A Wilkinson, LCPC

• Orthotic Fitter in Maryville, IL
• Providers in Maryville, IL by specialty
• Orthotic Fitter in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.