DR. MATTHEW M WIENECKE (NPI# 1104855089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104855089 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW M WIENECKE |
| Credential | MD |
| Practice Address |
9 Richland Medical Park Dr Suite 200a Columbia SC 29203-6859 |
| Mailing Address |
Po Box 743904 Atlanta GA 30374-3904 |
| Practice Telephone | 8034347940 |
| Practice Fax Number | 8034342262 |
| Mailing Telephone | 8032967303 |
| Mailing Fax Number | 8032967330 |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2018-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
14381 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 143810 | 05 |
| Street Address |
9 RICHLAND MEDICAL PARK DR SUITE 200A |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-6859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447257167 | John Martin Barlow | Otolaryngology | 9 Richland Medical Park Dr, Ste 510, Columbia, SC 29203-6859 | 2005-07-07 |
| 1225586399 | Lacey Humphries | Physician Assistant | 9 Richland Medical Park Dr, Suite 450, Columbia, SC 29203-6859 | 2016-09-16 |
| 1003261207 | Timothy Goode | Counselor | 9 Richland Medical Park Dr, Ste 440, Columbia, SC 29203-6859 | 2016-04-26 |
| 1629436050 | Jessica F Bailey | Physician Assistant | 9 Richland Medical Park Dr, Suite 450, Columbia, SC 29203-6859 | 2016-01-30 |
| 1427421544 | Adam Rodriguez | Physician Assistant | 9 Richland Medical Park Dr, Suite 450, Columbia, SC 29203-6859 | 2015-11-11 |
| 1447644596 | Allison Watkins | Nurse Practitioner | 9 Richland Medical Park Dr, Suite 450, Columbia, SC 29203-6859 | 2015-03-26 |
| 1568851970 | Jamie S Oliver | Dietitian, Registered | 9 Richland Medical Park Dr, Suite 505, Columbia, SC 29203-6859 | 2015-01-22 |
| 1609112515 | Karolyn S. Grafel | Physician Assistant | 9 Richland Medical Park Dr, Suite 450, Columbia, SC 29203-6859 | 2012-12-20 |
| 1912242876 | Palmetto Health | Ophthalmology | 9 Richland Medical Park Dr, Suite 340, Columbia, SC 29203-6859 | 2012-12-04 |
| 1801107321 | Phillip John Prest | Surgery | 9 Richland Medical Park Dr, Suite 450, Columbia, SC 29203-6859 | 2010-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475284 | Matthew Leon Brigmon | Surgery | 2 Richland Medical Park, Suite 300, Columbia, SC 29203 | 2020-10-23 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1811514482 | Esther Ruth Swan | Psychiatry & Neurology | Prisma Health General Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1447877014 | Jordan Kaitlyn Merrels | Psychiatry & Neurology | Prisma Health Medical Group General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1306463187 | Jessica Leigh Watson | Psychiatry & Neurology | Prisma Health General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-29 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1609493592 | Elizabeth Marie Kern | Orthopaedic Surgery | Prisma Health Medical Group Orthopedic Center, 2 Medical Park, Ste 105, Columbia, SC 29203 | 2020-06-26 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
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| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458943 | Allan James Shapiro | Pediatrics | 500 N Keene St, Ste 207, Columbia, MO 65201-8105 | 2005-06-21 |
| 1205325883 | Palmetto Health - University of South Carolina Medical Group | Pediatrics | 9 Richland Medical Park Dr Ste 110, Columbia, SC 29203-6859 | 2018-05-09 |
| 1164719894 | Margaret Alexander Gray | Pediatrics | 9 Richland Medical Park Dr Ste 110, Columbia, SC 29203-6859 | 2011-07-01 |
| 1346371143 | Peter Cummins Dyke II | Pediatrics | 500 N Keene St, Suite 207, Columbia, MO 65201-8104 | 2007-03-07 |
| 1275563629 | Luther Chase Williams IIi | Pediatrics | 9 Richland Medical Park Dr, Suite 110, Columbia, SC 29203-6859 | 2006-07-03 |
| 1700815271 | Claudius Osborne Shuler IIi | Pediatrics | 9 Richland Medical Park Dr, Suite 110, Columbia, SC 29203-6859 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720640337 | Hiroo Kinami | Pediatrics | Csb 424, Msc 613, 96 Jonathan Lucas Street, Charleston, SC 29425-0001 | 2019-07-03 |
| 1578504015 | Angela Sharkey | Pediatrics | 200 Patewood Dr Ste A200, Greenville, SC 29615-3580 | 2006-06-08 |
| 1346554714 | Stern Cardiology PC | Pediatrics | 196 Cardiology Drive, Rock Hill, SC 29732-1174 | 2010-07-28 |
| 1609191121 | Carolinas Physicians Network Inc | Pediatrics | 1656 Riverchase Blvd, Suite 2500, Rock Hill, SC 29732-2084 | 2010-03-29 |
| 1053564997 | University Medical Associates | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-10-23 |
| 1841411980 | Kimberly E Mchugh | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2007-05-02 |
| 1912060799 | John Flint Rhodes Jr. | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-3009 | 2006-12-19 |
| 1770663064 | Sinai Choi Zyblewski | Pediatrics | 171 Ashley Ave, Msc 915, Charleston, SC 29425 | 2006-10-17 |
| 1740378777 | George Hamilton Baker | Pediatrics | 165 Ashley Ave, Charleston, SC 29425-8905 | 2006-10-11 |
| 1699863811 | Susan Elizabeth Haynes | Pediatrics | 200 Patewood Dr Ste A200, Greenville, SC 29615-3580 | 2006-10-11 |
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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.