Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Richard Lee Wiesemann II

Individual provider Medical Physician Assistant · NPI 1629220488

Mr. Richard Lee Wiesemann II is a Physician Assistant in Coeur D Alene, Idaho. Qualified in 2008, 18 years ago. Practices with Kootenai Urgent Care LLC, an 18-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Montana.

Years since qualifying
18
Licensed in
ID, MT
In the registry since
2008
Specialties on file
2

Practice location Address checks out

980 W Ironwood Dr Ste 104
Coeur D Alene, ID 83814-2668
Phone: (208) 667-0621
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 700 W Ironwood Dr Ste 120, Coeur D Alene, ID 83814-4405 — (208) 625-3640

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-2733 (ID)
Physician Assistant Taxonomy 363A00000X · Licence MT 543 (MT)

Record details

NPI number1629220488
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 10, 2008
Last updated in NPPESApril 7, 2026
Certification dateApril 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Kootenai Urgent Care Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Coeur D Alene