Individual provider Active NPI

Alysha Weeter

  • Family Nurse Practitioner
  • Centerville, OH
National Provider Identifier
1053189407
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0026822 Issued in OH
Practice address
217 Amber Dr
Centerville, OH 45458-4939
Phone
(937) 510-4075
NPI assigned
Dec 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0026822 OH Primary

Addresses

Primary practice location

217 Amber Dr
Centerville, OH 45458-4939

Mailing address

217 Amber Dr
Centerville, OH 45458-4939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240604001870 OH Practitioner - Nurse Practitioner 1355883513 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0026822OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince May 14, 2024 Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

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": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1053189407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 AMBER DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454584939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 AMBER DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454584939",
            "telephone_number": "937-510-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEETER",
        "first_name": "ALYSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0026822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.