Individual provider Active NPI

William J. Wiedner, DC

  • Chiropractor
  • Stuart, FL
National Provider Identifier
1790716058
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 7269 Issued in FL
Practice address
931 SE Ocean Blvd
Stuart, FL 34994
Phone
(772) 781-1101
Fax
(772) 781-1141
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 7269 FL Primary

Addresses

Primary practice location

931 SE Ocean Blvd
Stuart, FL 34994

Mailing address

931 SE Ocean Blvd
Stuart, FL 34994-2425
Phone (772) 781-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110629000440 FL Practitioner - Chiropractic 8729266358 Practice locations: Stuart, FL
I20241203002176 FL Practitioner - Chiropractic 8729266358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 7269FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Harbour Medical Centers, LLC CurrentSince Nov 19, 2024 Accepting new patients
Wiedner Family Chiropractic PastSince Mar 1, 1997 Accepting new patients

Locations

1411 SE Ocean Blvd
Stuart, FL 34996
Phone (772) 283-8028

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1790716058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942425",
            "telephone_number": "772-781-1101",
            "fax_number": "772-781-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34994",
            "telephone_number": "772-781-1101",
            "fax_number": "772-781-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDNER",
        "first_name": "WILLIAM",
        "middle_name": "J.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.