DR. SCOTT DAVID WIEDENMANN (NPI# 1245340744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245340744 |
| Entity Type | Individual |
| Full Name | DR. SCOTT DAVID WIEDENMANN |
| Credential | M.D. |
| Practice Address |
128 Lagoon Forest Dr Ponte Vedra Beach FL 32082-2122 |
| Practice Telephone | 9042739591 |
| Practice Fax Number | 9042739591 |
| Mailing Telephone | 9042739591 |
| Mailing Fax Number | 9042739591 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME51674 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
128 LAGOON FOREST DR |
| City | PONTE VEDRA BEACH |
| State | FL |
| Zip Code | 32082-2122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576818 | Specialty Eye Surgeons, Pa | Ophthalmology | 240 Ponte Vedra Boulevard, Suite 202, Ponte Vedra Beach, FL 32082 | 2020-07-23 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1568988129 | Mustafa Bakir | General Practice | 1102 A1a, Ponte Vedra Beach, FL 32082 | 2017-08-16 |
| 1457890584 | Angelyn Sorgen | Nurse Practitioner | 1102 Hwy A1a, Suite 104, Ponte Vedra Beach, FL 32082 | 2017-02-22 |
| 1033575121 | Balanced Physician Care Pa | Family Medicine | 115 Professional Park Drive, Suite 104, Ponte Vedra Beach, FL 32082 | 2016-01-06 |
| 1528436060 | Robert Thompson II | Chiropractor | 135 Professional Drive, Suite 105, Ponte Vedra Beach, FL 32082 | 2015-09-14 |
| 1144628439 | Integrative Medical Group, Usa, LLC | Clinic/Center | 1102 A1a North, Suite 104, Ponte Vedra Beach, FL 32082 | 2014-12-18 |
| 1811308901 | Janice Wachtel, Phd, LLC | Psychologist | 100 Executive Way, Suite 110, Ponte Vedra Beach, FL 32082 | 2014-05-12 |
| 1578991154 | Nicole Theiler | Counselor | 171 Canal Blvd, Ponte Vedra Beach, FL 32082 | 2013-10-17 |
| 1982948006 | Daisamma Varghese | Nurse Practitioner | 860 A1an, Ponte Vedra, FL 32082 | 2012-11-15 |
| Find all providers in zip 32082 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265863757 | Raymond Balsys | Radiology | 1337 Ponte Vedra Blvd, Ponte Vedra Beach, FL 32082-4503 | 2013-12-09 |
| 1285747246 | Thomas Paganucci | Radiology | 24801 Deer Trace Dr, Ponte Vedra Beach, FL 32082-2188 | 2006-08-16 |
| 1235112517 | Megan E Deacon-casey | Radiology | 330 A1a N, Suite 322, Ponte Vedra Beach, FL 32082-1823 | 2005-11-21 |
| 1285870089 | Diagnostic Imaging Pa | Radiology | 330 A1a N, Suite 322, Ponte Vedra Beach, FL 32082-1823 | 2008-12-29 |
| 1932142114 | Paul L Vitulli | Radiology | 330 A1a N, Suite 322, Ponte Vedra Beach, FL 32082-1823 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588263941 | Pro Rad Imaging Services, LLC | Radiology | 81 N Hibiscus Dr, Miami Beach, FL 33139-5117 | 2020-10-18 |
| 1144834763 | Tower Imaging LLC | Radiology | 17416 Brookside Trace Ct., Tampa, FL 33647-3589 | 2020-09-01 |
| 1093325987 | Flagler Professional Health Care Services Inc. | Radiology | 351 Town Plaza Avenue, 101, Ponte Vedra, FL 32081 | 2020-08-05 |
| 1285243394 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 2488 E Irlo Bronson Memorial Hwy, Kissimmee, FL 34744-4948 | 2020-07-24 |
| 1790301661 | Clearview Diagnostic | Radiology | 8076 S Orange Blossom Trl, Orlando, FL 32809-7670 | 2020-06-17 |
| 1255956280 | Radiology Consultants of Hollywood Inc | Radiology | 310 W 41st St, Miami Beach, FL 33140-3603 | 2020-06-16 |
| 1366067712 | Baycare Outpatient Imaging LLC | Radiology | 711 S Dale Mabry Hwy, Tampa, FL 33609-4445 | 2020-06-11 |
| 1982225009 | Radiology and Nuclear Medicine Services LLC | Radiology | 1020 Nw 94th Ter, Plantation, FL 33322-4816 | 2020-04-29 |
| 1427679836 | Health Diagnostics of Fort Lauderdale, LLC | Radiology | 16604 Sheridan Street, Pembroke Pines, FL 33331 | 2020-04-27 |
| 1316576705 | Morton Plant Mease Health Services Inc | Radiology | 1840 Mease Dr Ste 103, Safety Harbor, FL 34695-6603 | 2020-04-07 |
| Find all providers with the same taxonomy | ||||
| City | PONTE VEDRA BEACH |
| Zip Code | 32082 |
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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.