Channing C Wiersema (NPI# 1457416166, PAC ID# 5991755605) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1457416166 |
| PAC ID by PECOS | 5991755605 |
| Professional Enrollment ID | I20050129000156 |
| Full Name | Channing C Wiersema |
| Organization Legal Name | ASCENSION ST MICHAEL'S HOSPITAL INC |
| Address |
190 Grand Seasons Dr Waupaca WI 54981-8219 |
| Phone Number | 7152583650 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL COLLEGE OF WISCONSIN |
| Graduation Year | 1994 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1850358938 |
| Number of Group Practice Members | 156 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520002 | ST MICHAEL'S HOSPITAL |
| 521334 | RIVERSIDE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 190 Grand Seasons Dr, Waupaca, WI 54981-8219 | 7152583650 | ASCENSION ST MICHAEL'S HOSPITAL INC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | ASCENSION ST MICHAEL'S HOSPITAL INC |
| Physicians | 139 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erik W. Gunderson | Obstetrics/gynecology | Ascension St Michael's Hospital Inc | 824 Illinois Ave, Stevens Point, WI 54481-3112 |
| Zoua Lor Yang | Nurse Practitioner | Ascension St Michael's Hospital Inc | 3500 Hoover Rd, Stevens Point, WI 54481-5600 |
| Promila K Timothy | Family Medicine | Ascension St Michael's Hospital Inc | 3301 Stanley St, Stevens Point, WI 54481-1323 |
| Kristina L Wattier | Psychiatry | Ascension St Michael's Hospital Inc | 122 Wilshire Blvd N, Stevens Point, WI 54481-1360 |
| Jeffrey L Willems | Psychologist, Clinical | Ascension St Michael's Hospital Inc | 3398 E Maria Dr, Stevens Point, WI 54481-1362 |
| Elise R Gorski | Physician Assistant | Ascension St Michael's Hospital Inc | 2401 Plover Rd, Plover, WI 54467-3916 |
| Frederick A Abrokwah | Hospitalist | Ascension St Michael's Hospital Inc | 900 Illinois Ave, Stevens Point, WI 54481-3114 |
| Xa X Xiong | Family Medicine | Ascension St Michael's Hospital Inc | 272 Christy St, Amherst, WI 54406-9390 |
| Orlando M Francisco | Family Medicine | Ascension St Michael's Hospital Inc | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 |
| Julie R Hintzman | Clinical Social Worker | Ascension St Michael's Hospital Inc | 209 Prentice St N, Stevens Point, WI 54481-1162 |
| Street Address |
190 GRAND SEASONS DR |
| City | WAUPACA |
| State | WI |
| Zip | 54981-8219 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Orlando M Francisco | Family Medicine | Ascension St Michael's Hospital Inc | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 |
| Carri L Schacherl | Nurse Practitioner | Ascension St Michael's Hospital Inc | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 |
| Christa J Hemmila | Nurse Practitioner | Ascension St Michael's Hospital Inc | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 |
| Lennet F Radke | Nurse Practitioner | Ascension St Michael's Hospital, Inc | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel L. Gauerke | Optometry | 815 W Fulton St, Suite 3, Waupaca, WI 54981-1405 | |
| Daniel R Everts | Optometry | 308 W Fulton St, Waupaca, WI 54981-1422 | |
| Stuart J Boelte | Chiropractic | 1326 Royalton St, Waupaca, WI 54981-1609 | |
| Gina M Koch | Chiropractic | Koch Chiropractic and Wellness Center | 418 School St, Waupaca, WI 54981-1626 |
| Jean L Rice | Chiropractic | Koch Chiropractic and Wellness Center | 418 School St, Waupaca, WI 54981-1626 |
| Chad A Cloutier | Chiropractic | 830 School St, Waupaca, WI 54981-1633 | |
| Carmen L Miller | Nurse Practitioner | Thedacare Incorporated | 710 Riverside Dr, Waupaca, WI 54981-1941 |
| Bradley Klein | Nurse Practitioner | Thedacare Incorporated | 710 Riverside Dr, Waupaca, WI 54981-1941 |
| Sarah C Durst | Family Medicine | Thedacare Incorporated | 710 Riverside Dr, Waupaca, WI 54981-1941 |
| Nancy A Pejsa | Nurse Practitioner | Thedacare Incorporated | 710 Riverside Dr, Waupaca, WI 54981-1941 |
| Find all physicians in zip 54981 | |||
| City | WAUPACA |
| Zip Code | 54981 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | WAUPACA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Channing C Wiersema.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.