Individual provider Active NPI

Deborah Lynn Weidinger, PHD

  • Psychologist
  • Leavenworth, KS
National Provider Identifier
1043381478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
825 KANSAS Issued in KS
Practice address
3515 S 4TH Street
Professional Association
Leavenworth, KS 66048
Phone
(913) 651-8415
Fax
(913) 772-8580
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

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
Psychologist 103T00000X 825 KANSAS KS Primary

Addresses

Primary practice location

3515 S 4TH Street
Professional Association
Leavenworth, KS 66048

Mailing address

1301 South Broadway
Leavenworth, KS 66048
Phone (913) 772-8264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151229001832 KS Practitioner - Clinical Psychologist 6204137789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

512 S 5TH St
Leavenworth, KS 66048-2611
Phone (913) 651-4123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
825 KANSASKSMDPsychologist

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043381478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SOUTH BROADWAY",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "66048",
            "telephone_number": "913-772-8264",
            "fax_number": "913-772-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 S 4TH STREET",
            "address_2": "PROFESSIONAL ASSOCIATION",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "66048",
            "telephone_number": "913-651-8415",
            "fax_number": "913-772-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDINGER",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "825 KANSAS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.