MR. RICHARD LEE WIESEMANN II (NPI# 1629220488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629220488 |
| Entity Type | Individual |
| Full Name | MR. RICHARD LEE WIESEMANN II |
| Practice Address |
1555 Liberty Ln Ste C Missoula MT 59808-2001 |
| Practice Telephone | 4067289545 |
| Mailing Telephone | 4067289545 |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2008-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MT 543 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306871793 | Richard J. Wiesemann | Radiology | 4001 Dutchmans Ln, Radiology, Louisville, KY 40207-4714 | 2006-07-12 |
| Street Address |
1555 LIBERTY LN STE C |
| City | MISSOULA |
| State | MT |
| Zip Code | 59808-2001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447720875 | Megan Elizabeth Galliford | Behavioral Analyst | 1647 Shindig Dr, Apt 303, Missoula, MT 59808 | 2018-11-28 |
| 1518473560 | Willow Mahana Nelson Griffith | Registered Nurse | 2829 Great Northern Loop Ste 300, Missoula, MT 59808 | 2017-12-28 |
| 1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
| 1558884064 | Sharon Marie Herndon | Nurse Practitioner | 2230 N Reserve St Ste 402, Missoula, MT 59808 | 2017-07-18 |
| 1427594761 | Erin Boggs | Specialist/Technologist | 2921 Dublin St, Missoula, MT 59808 | 2017-01-10 |
| 1942603287 | Benjamin Cody Mcintosh | Chiropractor | 1070 N. Russell St., Missoula, MT 59808 | 2014-10-01 |
| 1518219617 | Pure Medical Inc | Ambulance | 5515 Bonanza Place, Missoula, MT 59808 | 2012-10-12 |
| 1932462231 | Kathleen F Calcagno | Specialist/Technologist | 2615 Connery Way, Suite 2b, Missoula, MT 59808 | 2012-06-21 |
| 1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
| 1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
| Find all providers in zip 59808 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891269973 | Jason Enewold | Physician Assistant | 1424 Scott St, Missoula, MT 59802-2435 | 2019-01-11 |
| 1730664723 | Katrin Johanna Kahl | Physician Assistant | 5005 Pattee Canyon Rd, Missoula, MT 59803-1811 | 2018-09-26 |
| 1710230107 | Jennifer Culp | Physician Assistant | 900 N Orange St Ste 303, Missoula, MT 59802 | 2012-10-22 |
| 1083710313 | Mindy Opper | Physician Assistant | 825 W. Kent St., Missoula, MT 59801-6619 | 2006-09-15 |
| 1689770919 | Kelly Polus | Physician Assistant | 610 N California St, Missoula, MT 59802-3950 | 2006-09-15 |
| 1447363916 | Mary C Velk | Physician Assistant | 2835 Fort Missoula Rd Ste 202, Missoula, MT 59804-7424 | 2006-08-17 |
| 1477592236 | Michael R Beckel | Physician Assistant | 900 N Orange St Ste 106, Missoula, MT 59802-2951 | 2006-06-06 |
| 1316933963 | Jenifer Darlene Caldwell | Physician Assistant | 1224 Lincoln Rd, Missoula, MT 59802-3041 | 2005-09-20 |
| 1841841590 | Jacklyn Joan Pfister | Physician Assistant | 1201 Wyoming St, Missoula, MT 59801-1727 | 2019-09-24 |
| 1245889484 | Mitchell Mayfield | Physician Assistant | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2019-09-10 |
| Find all providers in MISSOULA | ||||
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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.