Individual provider Active NPI

Patrick E Weldon, M.D.

  • Neurology Physician
  • Jackson, MS
National Provider Identifier
1003907460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
W0718780 Issued in MS
Practice address
1860 Chadwick Drive
Suite 258
Jackson, MS 39204
Phone
(601) 376-2004
Fax
(601) 376-2006
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X W0718780 MS Primary

Addresses

Primary practice location

1860 Chadwick Drive
Suite 258
Jackson, MS 39204

Mailing address

1860 Chadwick Drive
Suite 258
Jackson, MS 39204
Phone (601) 376-2004

Other identifiers 1

IdentifierTypeStateIssuer
05236809MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050713000593 MS Practitioner - Neurology 5799711628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1030 N Flowood Dr
Suite a
Flowood, MS 39232-9532

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-2004

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Flowood, MS, CCN 257126
  • Merit Health River Oaks Hospital, Flowood, MS, CCN 250138
  • Merit Health Central Hospital, Jackson, MS, CCN 250072
  • Crossgates River Oaks Hospital Hospital, Brandon, MS, CCN 250096
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
  • University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

Merit-based Incentive Payment System (MIPS)

Final score
23.84 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
79.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
W0718780MSMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Axon CurrentSince Aug 1, 2005 Accepting new patients

Locations

1030 N Flowood Dr
Ste A
Jackson, MS 39232
Phone (601) 387-9005

5903 Ridgewood Rd
Jackson, MS 39211
Phone (601) 376-2022

1860 Chadwick Dr
Ste 258
Jackson, MS 39204
Phone (601) 376-2004

1030 N Flowood Dr
Jackson, MS 39232
Phone (601) 932-8622

Interoperability endpoints

  • Direct secure messaging: patrick.weldon.1@21875.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003907460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DRIVE",
            "address_2": "SUITE 258",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39204",
            "telephone_number": "601-376-2004",
            "fax_number": "601-376-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DRIVE",
            "address_2": "SUITE 258",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39204",
            "telephone_number": "601-376-2004",
            "fax_number": "601-376-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDON",
        "first_name": "PATRICK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "W0718780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05236809",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.