Michael A Wiencek, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN15583 Issued in MT

Practice address

1200 Westwood Dr
Hamilton, MT 59840-2345

Phone

(406) 363-2211

Fax

(406) 375-4590

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1770520769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WESTWOOD DR",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402345",
            "telephone_number": "406-363-2211",
            "fax_number": "406-375-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WESTWOOD DR",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402345",
            "telephone_number": "406-363-2211",
            "fax_number": "406-375-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENCEK",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "RN15583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770520769",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770520769",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770520769",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Wharton, DDS
• Jessie L Wheeler, DC
• Marshall W. White, MD
• Wholehearted Healing, PLLC
• Thaddeus J Widmer, L.C.S.W
• Wilderness Medics, Inc.
• Robert M Wilkins, O.D.
• Lauren Wilkinson
• William L. Suda, PH.D., P.C.
• Alicia Michele Williams, PA-C

• Certified Registered Nurse Anesthetist in Hamilton, MT
• Providers in Hamilton, MT by specialty
• Certified Registered Nurse Anesthetist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.