SUSAN CAROL WIECZOREK (NPI# 1013087386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013087386 |
| Entity Type | Individual |
| Full Name | SUSAN CAROL WIECZOREK |
| Credential | NP-C, CWOCN |
| Practice Address |
808 21st St Columbus GA 31904-8817 |
| Mailing Address |
7849 Gray Shoals Dr Columbus GA 31904-2121 |
| Practice Telephone | 7063213901 |
| Practice Fax Number | 7063213904 |
| Mailing Telephone | 7065875771 |
| Mailing Fax Number | 7063213904 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2014-02-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN042301 NP | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000901106C | 05 |
| Street Address |
808 21ST ST |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904-8817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760445753 | Anneliese Chai | Physician Assistant | 808 21st St, Columbus, GA 31904-8817 | 2006-04-10 |
| 1205207933 | Our Lady of The Roses Primary Care | Clinic/Center | 808 21st St, Columbus, GA 31904-8817 | 2015-10-07 |
| 1801119375 | Our Lady of The Roses Primary Care | General Practice | 808 21st St, Columbus, GA 31904-8817 | 2010-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566900 | Melissa Nameth | Nurse Practitioner | 3003 Cortona Rd, Columbus, OH 43204-4898 | 2020-10-18 |
| 1962019901 | Joshua Peltier | Nurse Practitioner | 2657 Summit St, Columbus, OH 43202-2434 | 2020-09-24 |
| 1891302949 | Lindsay Baughman | Nurse Practitioner | 5866 Regency Dr, Columbus, IN 47203-4551 | 2020-09-23 |
| 1114530706 | Renee Dawn Holloway-vaughan | Nurse Practitioner | 1317 Antietam Dr, Columbus, GA 31907-6887 | 2020-08-25 |
| 1063024354 | Nathaniel Z Raidel | Nurse Practitioner | 5699 Sandalwood Blvd, Columbus, OH 43229-3420 | 2020-08-19 |
| 1174134332 | Hailey Lyn Holman | Nurse Practitioner | 5141 W Broad St Ste 130, Columbus, OH 43228-1984 | 2020-08-12 |
| 1508475989 | Kara Shroff | Nurse Practitioner | 1127 Dublin Rd, Columbus, OH 43215-1005 | 2020-07-30 |
| 1265050553 | Mary Hoobler | Nurse Practitioner | 5059 N High St, Columbus, OH 43214-1589 | 2020-07-13 |
| 1417575200 | Candice Kilbarger | Nurse Practitioner | 2329 Keep Pl, Columbus, OH 43204-4989 | 2020-07-08 |
| 1295351872 | Christina Cotterman | Nurse Practitioner | 700 Children Dr, Columbus, OH 43205 | 2020-06-19 |
| Find all providers in COLUMBUS | ||||
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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.