James Roger Wieferich, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3506005 Issued in OH

Practice address

40 White Oak Professional Ctr
Vincent, OH 45784-9117

Phone

(740) 678-2374

Fax

(740) 678-8139

NPI assigned

Mar 15, 2006

Last updated

May 11, 2012By the provider in NPPES

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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336694400000",
    "number": "1992774772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 WHITE OAK PROFESSIONAL CTR",
            "city": "VINCENT",
            "state": "OH",
            "postal_code": "457849117",
            "telephone_number": "740-678-2374",
            "fax_number": "740-678-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEFERICH",
        "first_name": "JAMES",
        "middle_name": "ROGER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "3506005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0790916",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000699796",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RAILROAD",
            "identifier": "P01019339",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000678794",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052785000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Warren Local School District
• Denise Wasson
• White Oak Pharmacy LLC
• White Oak Pharmacy LLC
• Barbara J Wieferich, APRN, BC
• Lane Wilson, QMHS
• Erica Ladawn Winter

• Family Medicine Physician in Vincent, OH
• Providers in Vincent, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.