Active NPI
Donn J. Wiedershine, M.D., P.C.
- Family Medicine Physician
- Woodstock, NY
National Provider Identifier
1992934400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 166433-1
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 166433-1 | NY | Primary |
| Family Medicine Physician | 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 DirectoryLocations
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.
-
- Chiropractor
- Woodstock, NY
- NPI 1194951061
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.