Individual provider Active NPI

Matthew Alexander Weathers, PHARMD

  • Pharmacist
  • Slidell, TX
National Provider Identifier
1003225772
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
55292 Issued in TX
Practice address
138 County Road 2820
Box 152
Slidell, TX 76267-0152
Phone
(940) 389-6421
NPI assigned
Aug 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 55292 TX Primary

Addresses

Primary practice location

138 County Road 2820
Box 152
Slidell, TX 76267-0152

Mailing address

PO Box 152
Slidell, TX 76267-0152
Phone (940) 389-6421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
55292TXMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1003225772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 152",
            "city": "SLIDELL",
            "state": "TX",
            "postal_code": "762670152",
            "telephone_number": "940-389-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 COUNTY ROAD 2820",
            "address_2": "BOX 152",
            "city": "SLIDELL",
            "state": "TX",
            "postal_code": "762670152",
            "telephone_number": "940-389-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "MATTHEW",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "55292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.