NATHAN LYLE WIEDEMANN (NPI# 1518485796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518485796 |
| Entity Type | Individual |
| Full Name | NATHAN LYLE WIEDEMANN |
| Practice Address |
907 Lincoln Hwy W New Haven IN 46774-2141 |
| Mailing Address |
24624 Worden Rd Harlan IN 46743-9716 |
| Practice Telephone | 2604933736 |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2017-09-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 26027384A | IN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326570557 | Nathan Wiedemann | Family Medicine | 6949 Good Samaritan Dr, Cincinnati, OH 45247-5204 | 2017-03-28 |
| Street Address |
907 LINCOLN HWY W |
| City | NEW HAVEN |
| State | IN |
| Zip Code | 46774-2141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558376665 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 907 Lincoln Hwy W, New Haven, IN 46774-2141 | 2006-07-29 |
| 1902206170 | Edem Y Atakey | Pharmacist | 907 Lincoln Hwy W, New Haven, IN 46774-2141 | 2014-08-25 |
| 1528341633 | Richard L Cuney Jr. | Pharmacist | 907 Lincoln Hwy W, New Haven, IN 46774-2141 | 2011-09-25 |
| 1740563857 | Eric Adkins | Pharmacist | 907 Lincoln Hwy W, New Haven, IN 46774-2141 | 2011-09-25 |
| 1699058834 | Laura Ellen Keister | Pharmacist | 907 Lincoln Hwy W, New Haven, IN 46774-2141 | 2011-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235659236 | Tyann Nicole Sanchez | Doula | 16018 Platter Road, New Haven, IN 46774 | 2017-06-21 |
| 1073673430 | Benjamin Craig Swinehart | Physical Therapist | 10876 Isabelle Dr., New Haven, IN 46774 | 2006-12-08 |
| 1912930223 | Adams County Memorial Hospital | Skilled Nursing Facility | 1201 Daly Dr, New Haven, IN 46774 | 2006-07-09 |
| 1922520410 | Claressa Sue Brekke | Physical Therapist | 1316 Minnich Rd, New Haven, IN 46774 | 2017-07-17 |
| 1750558706 | Kristen Zurbuch Ms Ccc-slp | Speech-Language Pathologist | 3117 Pawnee Ct, New Haven, IN 46774 | 2008-05-09 |
| 1548442197 | Brackmann & Hockemeyer Optometry Inc | Optometrist | 1010 Boulder Ridge Trl, New Haven, IN 46774-0010 | 2007-12-05 |
| 1023349255 | Elzabeth K Hartup | Specialist | 8805 Edwardsberg Pl, New Haven, IN 46774-1079 | 2010-01-28 |
| 1417365958 | Jeremy Oyer | Physical Therapy Assistant | 8805 Edwardsberg Pl, New Haven, IN 46774-1079 | 2014-07-29 |
| 1467728204 | Jeremy Duane Stewart | Physical Therapy Assistant | 156 Sturm St, New Haven, IN 46774-1141 | 2012-03-27 |
| 1215313911 | Theresa Schortgen | Health Educator | 146 N Rufus St, New Haven, IN 46774-1162 | 2015-08-04 |
| Find all providers in zip 46774 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336757319 | Matthew Peter O'connell | Pharmacist | 55 Park Street, Lower Level, Department of Pharmacy, New Haven, CT 06510 | 2020-07-16 |
| 1477171460 | Huy Henry Le | Pharmacist | 20 York Street, Ps-ll, New Haven, CT 06510 | 2020-07-07 |
| 1487212635 | Brittany Clarissa Langdon | Pharmacist | 1450 Chapel St Rm V140n, New Haven, CT 06511-4405 | 2019-06-03 |
| 1841704277 | Daniela Alzate-molina | Pharmacist | 249 Legion Ave, New Haven, CT 06519-5508 | 2017-11-21 |
| 1639694698 | Sunil Kumar Tickoo | Pharmacist | Berneys Pharmacy, 615 Howard Ave, New Haven, CT 06519-2112 | 2017-08-10 |
| 1265893143 | Leon Cushman | Pharmacist | 1168 Whalley Ave, New Haven, CT 06515-1705 | 2016-03-18 |
| 1871997627 | Bhumi Patel | Pharmacist | 44 Orange St, Apt 523, New Haven, CT 06510-3130 | 2014-10-22 |
| 1356612634 | David Eld | Pharmacist | 55 Park Street, Suite 1a, New Haven, CT 06511 | 2012-01-19 |
| 1780954719 | Rebecca Reeve | Pharmacist | 53 Park St, New Haven, CT 06511-5474 | 2012-01-06 |
| 1841568441 | Pamela Cavallo | Pharmacist | 55 Park St., New Haven, CT 06511 | 2011-12-09 |
| Find all providers in NEW HAVEN | ||||
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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.