MR. JON M WIESELER PT
Complete NPI Record 1295890804
Physical Therapist in North Platte, NE

NPI Status: Active since December 26, 2006

Contact Information

1001 SOUTH COTTONWOOD
NORTH PLATTE, NE
ZIP 69101
Phone: (308) 532-5480
Fax: (308) 532-5480

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Complete NPI Dataset

This page represents the complete record for NPI 1295890804. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1295890804
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
The last name of the provider. If the provider is an individual, this is the legal name.
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: JON
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Middle Name: M
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: PT
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 1001 SOUTH COTTONWOOD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: NORTH PLATTE
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NE
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 691016138
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 3085325480
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 3085325480
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 1001 SOUTH COTTONWOOD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: NORTH PLATTE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NE
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 691016138
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3085325480
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3085325480
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 12/26/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 7/8/2007
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Gender Code: M
Healthcare Provider Taxonomy Code 1: 225100000X
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Provider License Number 1: 546
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Provider License Number State Code 1: NE
Healthcare Provider Primary Taxonomy Switch 1: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Other Provider Identifier 1: 10024973400
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: NE
Other Provider Identifier 2: 39616
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: NE
Other Provider Identifier Issuer 2: BCBS
Other Provider Identifier 3: CK7267
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: NE
Other Provider Identifier Issuer 3: RR MEDICARE
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No