Organization Active NPI

Donn J. Wiedershine, M.D., P.C.

  • Family Medicine Physician
  • Woodstock, NY
National Provider Identifier
1992934400
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
166433-1 Issued in NY
Legal business name
DONN J. WIEDERSHINE, M.D., P.C.
Practice address
62 Ricks Road
Woodstock, NY 12498
Phone
(848) 208-1312
Fax
(845) 679-2409
NPI assigned
Jul 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Donn Jay Wiedershine, M.D.
Title
Medical Director
Phone
(845) 679-2709

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 166433-1 NY Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X

Addresses

Primary practice location

62 Ricks Road
Woodstock, NY 12498

Mailing address

62 Ricks Road
Woodstock, NY 12498
Phone (848) 208-1312

National Provider Directory

National Provider Directory

Locations

18 E 41st St
#402
New York, NY 10017
Phone (646) 286-1286

62 Ricks Rd
Woodstock, NY 12498
Phone (845) 399-6022

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1992934400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 RICKS ROAD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "12498",
            "telephone_number": "848-208-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 RICKS ROAD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "12498",
            "telephone_number": "848-208-1312",
            "fax_number": "845-679-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONN J. WIEDERSHINE, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-06",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "WIEDERSHINE",
        "authorized_official_first_name": "DONN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "845-679-2709",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "166433-1",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.