Active NPI
Lacey Wiegmann
- Physical Therapist
- Greenville, IL
National Provider Identifier
1922485127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.021294
- Practice address
- 200 Health Care Dr
Greenville, IL 62246-1154 - Phone
- (618) 664-2626
- NPI assigned
- Apr 27, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.021294 | IL | Primary |
Addresses
Primary practice location
200 Health Care Dr
Greenville, IL 62246-1154
Mailing address
15 Apex Dr
Highland, IL 62249-1282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.021294 | IL | MD | Physical Therapist |
Organizations & group practices 1
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.
-
- Specialist
- Highland, IL
- NPI 1033166061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1922485127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 APEX DR",
"city": "HIGHLAND",
"state": "IL",
"postal_code": "622491282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HEALTH CARE DR",
"city": "GREENVILLE",
"state": "IL",
"postal_code": "622461154",
"telephone_number": "618-664-2626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEGMANN",
"first_name": "LACEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-27",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.021294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.