Stacey Weatherbee, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN004413 Issued in PA

Practice address

120 Valley Green LN Ste 510
King of Prussia, PA 19406-2080

Phone

(484) 476-6320

Fax

(484) 476-7802

NPI assigned

Sep 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1053961862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 VALLEY GREEN LN STE 510",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062080",
            "telephone_number": "484-476-6320",
            "fax_number": "484-476-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 VALLEY GREEN LN STE 510",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062080",
            "telephone_number": "484-476-6320",
            "fax_number": "484-476-7802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 General Scott Rd",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "PA",
            "postal_code": "190871309",
            "country_code": "US",
            "telephone_number": "610-554-3214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEATHERBEE",
        "first_name": "STACEY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warby Parker Inc.
• Allison Louise Ward
• Matthew Ward, M.ED., BCBA
• Emily Watts, ASST BEHAVIOR ANALYS
• Melissa Wawrzynek, DPM
• Ashley Weaver, LPC
• Nicole Weaver
• Stuart A Weber, D.O.
• Shanda Weeden
• Amanda Weeks

• Registered Dietitian in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.