Active NPI
John C. Weiks, ED.D.
- Psychologist
- Grand Rapids, MI
National Provider Identifier
1053434357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301004073
- Practice address
- 2707 Breton Rd SE
Grand Rapids, MI 49546-5633 - Phone
- (616) 822-9714
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301004073 | MI | Primary |
Addresses
Primary practice location
2707 Breton Rd SE
Grand Rapids, MI 49546-5633
Mailing address
2707 Breton Rd SE
Grand Rapids, MI 49546-5633
Phone (616) 822-9714
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359417600000",
"number": "1053434357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2707 BRETON RD SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495465633",
"telephone_number": "616-822-9714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2707 BRETON RD SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495465633",
"telephone_number": "616-822-9714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIKS",
"first_name": "JOHN",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2013-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301004073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.