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CAROLYN POWERS WIERSMA
NPI 1780070805
Psychiatry & Neurology - Child & Adolescent Psychiatry in Chinle, AZ

Active since April 15, 2015PECOS EnrolledAccepts Medicare Assignment
US HIGHWAY 191 & HOSPITAL ROAD, CHINLE, AZ 86503(864) 884-7879 Get Directions Write a Review

NPPES record last updated: October 2, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Carolyn Powers Wiersma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAROLYN POWERS WIERSMA (NPI 1780070805) is an individual child & adolescent psychiatry provider in Chinle, Arizona, licensed in Pennsylvania (MD463873) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS and is a graduate of Medical University Of South Carolina College Of Medicine (2015).

NPPES Registry Identity

NPI1780070805
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameCAROLYN POWERS WIERSMA
Location AddressUS HIGHWAY 191 & HOSPITAL ROADChinle, AZ 86503
Mailing AddressPo Box PhChinle, AZ 86503-8000 · (864) 884-7879
Phone(864) 884-7879
Sole ProprietorNo
Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 2015
Enumeration DateApril 15, 2015
Last NPPES UpdateOctober 2, 2020
NPPES CertifiedOctober 1, 2020
✔ NPI 1780070805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in PA · MD463873
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
US HIGHWAY 191 & HOSPITAL ROAD, Chinle, AZ 86503
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carolyn Powers Wiersma is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42630386
PECOS Enrollment IDI20201026002326
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Carolyn Wiersma reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dhhs Phs Naihs Chinle Comprehensive Health Care Facility
329 mi
General Acute Care Hospital
NAVAJO ROUTE 4
Pinon, AZ 86510
  • Reassigned Medicare billing, Texas enrollment
  • 476 clinicians in this Medicare group
NPI 1396761565 (928) 725-3220

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carolyn Wiersma's NPI number?

The NPI number for Carolyn Wiersma is 1780070805. It was assigned to this individual provider in the NPPES registry on April 15, 2015.

Where is Carolyn Wiersma located?

Carolyn Wiersma practices at Us Highway 191 & Hospital Road, Chinle, AZ 86503. The listed phone number is (864) 884-7879.

What is Carolyn Wiersma's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Carolyn Wiersma enrolled in Medicare?

Yes. Carolyn Wiersma is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Carolyn Wiersma's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Wiersma reassigns Medicare benefits to Dhhs Phs Naihs Chinle Comprehensive Health Care Facility (Pinon, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carolyn Wiersma's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Carolyn Wiersma was last updated on October 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.