Kathleen Marie Wiese (NPI# 1790987923, PAC ID# 7214020809) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROLOGY.
| Nation Provider ID (NPI) | 1790987923 |
| PAC ID by PECOS | 7214020809 |
| Professional Enrollment ID | I20160311002117 |
| Full Name | Kathleen Marie Wiese |
| Organization Legal Name | COASTAL INPATIENT PHYSICIANS LLC |
| Address |
9300 Medical Plaza Dr Charleston SC 29406-9334 |
| Phone Number | 8438474372 |
| Gender | F |
| Graduation Year | 2002 |
| Primary Specialty | NEUROLOGY |
| Group Practice PAC ID | 4688671365 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420079 | TRIDENT MEDICAL CENTER |
| 420030 | COLLETON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 9300 Medical Plaza Dr, Charleston, SC 29406-9334 | 8438474372 | COASTAL INPATIENT PHYSICIANS LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_047_overall | Care Plan | 87% | |
| MIPS_EC_047_overall | Care Plan | 87% | |
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 28% | |
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 28% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_134_overall | Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan | 100% | |
| MIPS_EC_134_overall | Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan | 100% |
| Organization Legal Name | COASTAL INPATIENT PHYSICIANS LLC |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Fazal M Khan | Psychiatry | Coastal Inpatient Physicians LLC | 501 Robertson Blvd, Walterboro, SC 29488-2787 |
| Yevgeniy Gelfand | Internal Medicine | Coastal Inpatient Physicians LLC | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 |
| Holly B Miller | Physician Assistant | Coastal Inpatient Physicians LLC | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 |
| Karen R Smith | Nurse Practitioner | Coastal Inpatient Physicians LLC | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 |
| Charles G Shissias | Neurology | Coastal Inpatient Physicians LLC | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 |
| Jeffrey S Cluver | Psychiatry | Coastal Inpatient Physicians LLC | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 |
| Julio Rentas Reyes | Neurology | Coastal Inpatient Physicians LLC | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 |
| Thomas A Privett | Neurology | Coastal Inpatient Physicians LLC | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 |
| Meenakshi Parmar | Psychiatry | Coastal Inpatient Physicians LLC | 501 Robertson Blvd, Walterboro, SC 29488-2787 |
| Maria Elena Moreno | Psychiatry | Coastal Inpatient Physicians LLC | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 |
| Street Address |
9300 MEDICAL PLAZA DR |
| City | CHARLESTON |
| State | SC |
| Zip | 29406-9334 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark A Coker | Cardiovascular Disease (cardiology) | Palmetto Primary Care Physicians | 2550 Elms Ctr Rd, N Charleston, SC 29406 |
| Mary L Bowen | Nurse Practitioner | Palmetto Primary Care Physicians | 2550 Elms Ctr Rd, N Charleston, SC 29406 |
| Jason B Coker | Internal Medicine | Palmetto Primary Care Physicians | 2550 Elms Ctr Rd, N Charleston, SC 29406 |
| Dana West | Nurse Practitioner | Palmetto Primary Care Physicians | 2550 Elms Ctr Rd, N Charleston, SC 29406 |
| Victoria M Adams | Nurse Practitioner | Palmetto Primary Care Physicians | 2550 Elms Ctr Rd, N Charleston, SC 29406 |
| Kirsten Lynn Paris | Physician Assistant | Palmetto Primary Care Physicians | 2550 Elms Ctr Rd, North Charleston, SC 29406 |
| Jack Stansbury | Nurse Practitioner | Palmetto Primary Care Physicians | 2550 Elms Ctr Rd, N Charleston, SC 29406 |
| Jennifer M Lesslie | Optometry | 1370 Remount Rd, Suite B, N Charleston, SC 29406-3322 | |
| Francis Akom | Obstetrics/gynecology | 1370 Remount Rd D, North Charleston, SC 29406-3322 | |
| Michael David Schall | Optometry | 1415 Remount Rd, N Charleston, SC 29406-3326 | |
| Find all physicians in zip 29406 | |||
| City | CHARLESTON |
| Zip Code | 29406 |
| Specialty | NEUROLOGY |
| City + Specialty | CHARLESTON + NEUROLOGY |
Please comment or provide details below to improve the information on Kathleen Marie Wiese.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.