Individual provider Active NPI

Joseph A Wieck, MD

  • Orthopaedic Surgery Physician
  • Panama City, FL
National Provider Identifier
1750354221
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME143674 Issued in FL
Practice address
25 Doctor Drive
Medical Plaza 2
Panama City, FL 32405-4520
Phone
(850) 767-2455
Fax
(850) 767-2790
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME143674 FL Primary

Addresses

Primary practice location

25 Doctor Drive
Medical Plaza 2
Panama City, FL 32405-4520

Mailing address

PO Box 370
Fortson, GA 31808-0370

Other practice location 1

300 Stonecrest Blvd Ste 200
Smyrna, TN 37167-6800
Phone (615) 355-0533

Other practice location 2

394 Harding Pl Ste 200
Nashville, TN 37211-3980
Phone (615) 834-4482

Other identifiers 2

IdentifierTypeStateIssuer
193771OtherTNBCBS
3083053MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040712001554 TN Practitioner - Orthopedic Surgery 1456265743 Reassigns benefits to 1 organization
I20200303001441 FL Practitioner - Orthopedic Surgery 1456265743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Tennessee, HSC, College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hughston Clinic Southeast PCGroup PAC ID 9234423971, 48 clinicians

Practice addresses (Care Compare)

341 Racetrack Rd NW
Suite B
Fort Walton Beach, FL 32547-1788
Phone (850) 226-8112

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedics & Sports Medicine, PLC Orthopaedic Surgery CurrentSince Jan 1, 1996 Accepting new patients
Premier Orthopaedics & Sports Medicine PLC Orthopaedic Surgery Current Accepting new patients
Hughston Clinic Southeast PC Orthopaedic Surgery CurrentSince Jan 11, 2020 Accepting new patients
Hughston Clinic Southeast PC CurrentSince Jan 11, 2020 Accepting new patients
Premier Orthopaedics & Sports Medicine, PLC CurrentSince Jan 1, 1996 Accepting new patients

Locations

341 Racetrack Rd NW
Ste B
Fort Walton Beach, FL 32547
Phone (850) 226-8112

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

449 W 23rd St
Panama City, FL 32405
Phone (850) 747-7900

25 Doctors Dr
#2
Panama City, FL 32405
Phone (850) 767-2455

1321 Murfreesboro Pike
Ste 510
Nashville, TN 37217
Phone (615) 366-8890

394 Harding Pl
Ste 200
Nashville, TN 37211
Phone (615) 834-4482

300 Stonecrest Blvd
Ste 200
Smyrna, TN 37167
Phone (615) 220-4747

Interoperability endpoints

  • Direct secure messaging: joseph.wieck.2@321.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1750354221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "fax_number": "706-494-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 DOCTOR DRIVE",
            "address_2": "MEDICAL PLAZA 2",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054520",
            "telephone_number": "850-767-2455",
            "fax_number": "850-767-2790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Stonecrest Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "TN",
            "postal_code": "371676800",
            "country_code": "US",
            "telephone_number": "615-355-0533",
            "fax_number": "615-355-0957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "394 Harding Pl Ste 200",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372113980",
            "country_code": "US",
            "telephone_number": "615-834-4482",
            "fax_number": "615-834-4722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIECK",
        "first_name": "JOSEPH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME143674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "193771",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3083053",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.