DR. JACOB ANTHONY WIESEN (NPI# 1831317346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831317346 |
| Entity Type | Individual |
| Full Name | DR. JACOB ANTHONY WIESEN |
| Credential | M.D. |
| Practice Address |
2540 N Healthy Way Fremont NE 68025-2315 |
| Practice Telephone | 4027216333 |
| Mailing Telephone | 4027216333 |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2016-01-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 5413 | NE | Allopathic & Osteopathic Physicians |
| Street Address |
2540 N HEALTHY WAY |
| City | FREMONT |
| State | NE |
| Zip Code | 68025-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053858860 | Fremont Health Clinic | Physician Assistant | 2540 N Healthy Way, Fremont, NE 68025-2315 | 2017-01-31 |
| 1841737467 | Brittany N Burbach | Nurse Practitioner | 2540 N Healthy Way, Fremont, NE 68025-2315 | 2017-01-20 |
| 1235458357 | Jamie Haferbier Gustafson | Obstetrics & Gynecology | 2540 N Healthy Way, Fremont, NE 68025-2315 | 2010-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710456934 | Methodist Fremont Health | Pharmacy | 450 E 23rd, Fremont, NE 68025 | 2018-11-16 |
| 1811484546 | Cynthia Jane Cusick | Social Worker | 748 North Main Street, Fremont, NE 68025 | 2018-04-18 |
| 1891298196 | Hergenrader Dental Rehab PC | Dentist | 3102 East Elk Lane, Fremont, NE 68025 | 2018-03-13 |
| 1982142857 | Paula Y. Walla | Speech-Language Pathologist | 130 E. 9th St., Fremont, NE 68025 | 2017-02-10 |
| 1619326709 | Debra Baker | Nurse Practitioner | 3140 Elk Ln Ste 600, Fremont, NE 68025 | 2016-06-09 |
| 1912368069 | Nicole Henkel | Occupational Therapist | 450 East 23rd, Fremont, NE 68025 | 2016-03-17 |
| 1265818017 | Orchid of Hope Counseling | Exclusive Provider Organization | 1919 North Broad Street, Fremont, NE 68025 | 2015-08-04 |
| 1265770366 | James N Orr | Pharmacist | 840 E 23 St, Fremont, NE 68025 | 2013-01-24 |
| 1902156086 | Penelope Anastasia Stoll | Speech-Language Pathologist | Nye Legacy, 3210 N. Clarkson St, Fremont, NE 68025 | 2012-09-14 |
| 1144582685 | Diane Marie Gehring | Case Management | 105 East 12th Street, Fremont, NE 68025 | 2012-06-11 |
| Find all providers in zip 68025 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073712162 | Advanced Multi Specialty Medical Group | General Practice | 37471 Fremont Blvd, Fremont, CA 94536-3704 | 2007-07-17 |
| 1639599160 | Ford Brewer Md, Inc | General Practice | 45500 Fremont Blvd, Fremont, CA 94538-6326 | 2014-04-23 |
| 1235318288 | Dr Daniel Kelderhouse Inc | General Practice | 201 S Park Ave, Fremont, OH 43420-2953 | 2007-10-26 |
| 1215137567 | Rickey Wright Md LLC | General Practice | 1823 W State St, Fremont, OH 43420-1635 | 2007-07-24 |
| 1497883599 | Yu-hong Law | General Practice | 2147 Mowry Ave, Ste D3, Fremont, CA 94538-1724 | 2007-03-01 |
| 1629090956 | Rickey Wright | General Practice | 1823 W State St, Fremont, OH 43420-1635 | 2006-07-24 |
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| 1225658495 | Grand Island Regional Medical Center | General Practice | 3533 Prairieview St., Grand Island, NE 68802-5225 | 2020-04-17 |
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| 1194202358 | Lmmc Lincoln, LLC | General Practice | 300 N 44th St Ste 102, Lincoln, NE 68503-3415 | 2018-07-20 |
| 1649629478 | Marathon Health, Inc. | General Practice | 108 West 17th Street, C/o Cargill Employee Health Center, Schuyler, NE 68661-1304 | 2016-06-13 |
| 1356605117 | Laura Marie Peterson | General Practice | 8330 Cheney Ridge Rd Apt 439, Lincoln, NE 68516-3820 | 2012-06-26 |
| 1013283431 | Daniel J Gross | General Practice | 1501 Jackson St Ste 100, Omaha, NE 68102-3146 | 2012-03-29 |
| 1043583560 | Virgil V Ottun | General Practice | 81084 Round Valley Rd, Sargent, NE 68874-3119 | 2012-02-14 |
| 1255644787 | Joseph Kennedy Costello Iv | General Practice | 224 N. 49th St. #4a, Omaha, NE 68132 | 2010-07-26 |
| 1326369075 | Gbgh | General Practice | 12309 Gold Street, Omaha, NE 68144-2760 | 2010-06-17 |
| 1477875649 | James Bane | General Practice | 11106 N 61st St, Omaha, NE 68152-1470 | 2010-02-15 |
| Find all providers with the same taxonomy | ||||
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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.