JOEL WIETFELDT (NPI# 1497977888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497977888 |
| Entity Type | Individual |
| Full Name | JOEL WIETFELDT |
| Credential | MD |
| Practice Address |
2901 Greenbriar Dr Springfield IL 62704-6425 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2175287541 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-05-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
036129983 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
2901 GREENBRIAR DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-6425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457461766 | Beth A. Bergman | Plastic Surgery | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2006-08-30 |
| 1730676305 | Sharon E. Burger | Registered Nurse | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2018-04-18 |
| 1952786311 | Aubrie Hubbert | Nurse Practitioner | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2015-07-28 |
| 1265743140 | Abigail Maciolek Cochran | Surgery | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2010-06-25 |
| 1134229826 | Raj K. Sinha | Plastic Surgery | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2006-09-23 |
| 1710097993 | Richard E. Brown | Plastic Surgery | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871781765 | Andrew J Kochevar | Surgery | 1229 E Seminole St Ste 340, Springfield, MO 65804 | 2007-10-04 |
| 1780066738 | Timothy Daugherty | Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2015-06-26 |
| 1730561796 | James Winters | Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2015-06-25 |
| 1205241221 | Lauren Hutchinson | Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2014-06-28 |
| 1568881407 | Connor Barnes | Surgery | 3555 S National Ave, Springfield, MO 65807-7310 | 2014-04-08 |
| 1265743140 | Abigail Maciolek Cochran | Surgery | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2010-06-25 |
| 1366762932 | Pioneer Valley Plastic Surgery LLC | Surgery | 100 Wason Ave, Suite 360, Springfield, MA 01107-1119 | 2010-06-07 |
| 1881913002 | Steven J Covici Md Facs PC | Surgery | 125 Liberty St, Suite 308, Springfield, MA 01103-1114 | 2010-05-27 |
| 1689896144 | Erika Henkelman | Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2007-05-03 |
| 1851327662 | Bharat Shah | Surgery | 1229 E Seminole St, Springfield, MO 65804-2227 | 2006-06-23 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.