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WILDWOOD INTERNAL MEDICINE, PC
NPI 1871726067
Internal Medicine in Wildwood, MO

Active since September 03, 2009CLIA 26D0857265 · Waiver
16759 MAIN STREET, SUITE 203, WILDWOOD, MO 63040(636) 458-4800(636) 594-7500 Get Directions Write a Review

NPPES record last updated: September 3, 2009. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Wildwood Internal Medicine, Pc NPPES

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

WILDWOOD INTERNAL MEDICINE, PC (NPI 1871726067) is a healthcare organization registered as an internal medicine in Wildwood, Missouri and active in the NPI registry since September 2009. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists John Wiedner, Present, as its authorized official.

NPPES Registry Identity

NPI1871726067
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameWILDWOOD INTERNAL MEDICINE, PC
Location Address16759 MAIN STREET, SUITE 203Wildwood, MO 63040
Mailing Address16759 Main Street, Suite 203Wildwood, MO 63040 · (636) 458-4800 · Fax (636) 594-7500
Phone(636) 458-4800
Fax(636) 594-7500
Organization SubpartYes
Authorized OfficialJohn WiednerPresent · (636) 458-4800
Enumeration DateSeptember 3, 2009
✔ NPI 1871726067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
16759 MAIN STREET, Wildwood, MO 63040
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0857265

Wildwood Internal Medicine, PC · Wildwood, MO
Active · expires Aug 31, 2026
CLIA Number26D0857265
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJohn F. Wiedner
Laboratory Phone(636) 458-4800
Laboratory LocationWildwood Internal Medicine, PC16759 Main Street Ste 203, Wildwood, MO 63040
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Wildwood Internal Medicine, PC's NPI number?

The NPI number for Wildwood Internal Medicine, PC is 1871726067. It was assigned to this organization in the NPPES registry on September 3, 2009.

Where is Wildwood Internal Medicine, PC located?

Wildwood Internal Medicine, PC is located at 16759 Main Street Suite 203, Wildwood, MO 63040. The listed phone number is (636) 458-4800.

What is Wildwood Internal Medicine, PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Wildwood Internal Medicine, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0857265) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wildwood Internal Medicine, PC was last updated on September 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.