KYLE MICHAEL WIEDEMER (NPI# 1750905972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750905972 |
| Entity Type | Individual |
| Full Name | KYLE MICHAEL WIEDEMER |
| Practice Address |
121 N 9th St Williamsburg KY 40769-1704 |
| Practice Telephone | 5026939878 |
| Mailing Telephone | 5026939878 |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
121 N 9TH ST |
| City | WILLIAMSBURG |
| State | KY |
| Zip Code | 40769-1704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535810 | Norvell Family Dentistry Pllc | Clinic/Center | 821 W. Hwy 25w, Williamsburg, KY 40769 | 2020-10-15 |
| 1730710724 | Heidi Marie Zwick | Specialist/Technologist | 6790 College Station Drive, Williamsburg, KY 40769 | 2020-01-29 |
| 1841764271 | Dayspring Health Inc | Clinic/Center | 640 West Highway 92, Williamsburg, KY 40769 | 2019-01-18 |
| 1649713728 | William Linscomb | Specialist/Technologist | 207 Circle Ave Apt8, Williamsburg, KY 40769 | 2016-11-22 |
| 1881137883 | Ashley Konrad | Specialist/Technologist | 6790 College Station Dr, Williamsburg, KY 40769 | 2016-11-22 |
| 1053680421 | Michael C Culver | Veterinarian | 319 Tackett Creek Rd, Williamsburg, KY 40769 | 2011-12-14 |
| 1942586060 | Smith and Brown Family Dentistry | Dentist | 821 S Hwy 25w, Williamsburg, KY 40769 | 2011-11-03 |
| 1346537271 | Kayla Fields | Dentist | 640 W Highway 92, Williamsburg, KY 40769 | 2011-06-29 |
| 1407154800 | Jellico Community Hospital, Inc | Nurse Practitioner | 998 South Highway 25w, Willaimsburg, KY 40769 | 2011-03-09 |
| 1568614543 | Family Health Care Associates of Williamsburg | Nurse Practitioner | 965 South Hwy 25, Ste 52, Williamsburg, KY 40769 | 2008-10-21 |
| Find all providers in zip 40769 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982201760 | Jaime Lyn Van Kirk | Student in an Organized Health Care Education/Training Program | 233 Padgetts Ordinary, Williamsburg, VA 23185-5578 | 2020-10-05 |
| 1760006753 | Annalisa Layfield Vargas | Student in an Organized Health Care Education/Training Program | 100 W Sycamore St Apt 14, Williamsburg, KY 40769-1909 | 2020-06-04 |
| 1821612235 | Abigail Murphy | Student in an Organized Health Care Education/Training Program | 226 Circle Ave, Williamsburg, KY 40769-1326 | 2020-06-01 |
| 1912563479 | Trista Rosing | Student in an Organized Health Care Education/Training Program | 5423 Williamsburg Rd, Williamsburg, MI 49690 | 2019-05-10 |
| 1649770736 | James Edward Mclean | Student in an Organized Health Care Education/Training Program | 133 Links of Leith, Williamsburg, VA 23188-7465 | 2018-02-15 |
| 1831647882 | Raven Walker | Student in an Organized Health Care Education/Training Program | 105 Williamson Dr, Williamsburg, VA 23188-3006 | 2016-09-20 |
| 1942503552 | University of The Cumberlands | Student in an Organized Health Care Education/Training Program | 6180 College Station Dr, Williamsburg, KY 40769-1372 | 2010-12-21 |
| 1295351138 | Jimmy Deaton | Student in an Organized Health Care Education/Training Program | 6178 College Station Dr, Williamsburg, KY 40769-1372 | 2020-06-16 |
| 1578196382 | Ariel Tal | Student in an Organized Health Care Education/Training Program | 247 Mclaws Cir, Williamsburg, VA 23185-5660 | 2020-02-20 |
| 1508499674 | Retecka Bright | Student in an Organized Health Care Education/Training Program | 247 Mclaws Cir, Williamsburg, VA 23185-5660 | 2020-02-18 |
| Find all providers in WILLIAMSBURG | ||||
| City | WILLIAMSBURG |
| Zip Code | 40769 |
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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.