Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1801866744 Individual Practitioner Male Practitioner

Kim Keith Wiese , PA-C

Physician Assistant • Peoria, IL

Professional Overview & Biography Verified Profile Summary

Kim Wiese, PA-C is a registered healthcare professional specializing in Physician Assistant in Peoria, IL. Practice services are available at 1524 W GLEN AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1524 W Glen Ave

Peoria, IL 616144692

Telephone 3095120902
Fax 0940303973
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 11.7 Yrs
Regional Practice Density
96 Specialists

Practicing in Peoria, IL (4958 Statewide)

Telehealth Adoption Rate
10.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-05-19
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IL 085.006503

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Amber Jones , MSN, APRN, FNP-BC

Nurse Practitioner - Family

NPI 1396248464

Master of Science in Nursing, Advanced Practice Registered Nurse, Family Nurse Practitioner (Board Certified)

Kelsey Casolari , APRN

Nurse Practitioner - Family

NPI 1477104685

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location May 19, 2020

Registered at 1524 W GLEN AVE, PEORIA, IL 616144692 (Tel: 3095120902)

📍
Updated Business Mailing Address May 19, 2020

Registered at 1524 W GLEN AVE, PEORIA, IL 616144692 (Tel: 3095120902)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 19, 2020

Physician Assistant (License #085.006503 in IL)

📍
Updated Business Mailing Address January 30, 2019

Registered at PO BOX 1330, NORMAN, OK 730701330 (Tel: 4053076668)

NPI Profile Active August 26, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location August 26, 2008

Registered at 724 24TH AVE NW, #200, NORMAN, OK 730696214 (Tel: 4053606868)

📍
Updated Business Mailing Address August 26, 2008

Registered at 724 24TH AVE NW, #200, NORMAN, OK 730696214 (Tel: 4053606868)

👤
Provider Name / Credentials Updated August 26, 2008

Recorded as KIM WIESE, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 26, 2008

Physician Assistant (License #PA 300 in OK)

🟢
Initial NPI Registration & Enumeration January 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801866744
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 24, 2006
Last Update: May 19, 2020
Sole Proprietor: No

Mailing Address

1524 W Glen Ave

Peoria, IL 616144692

Phone: 3095120902

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.