Active NPI
Erica Diane Weber
- Pharmacist
- Marshall, IL
National Provider Identifier
1063012813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.301875
- Practice address
- 108 Kyden Drive
Marshall, IL 62441 - Phone
- (217) 826-8013
- NPI assigned
- Oct 30, 2020
- Last updated
- Oct 30, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.301875 | IL | Primary |
Addresses
Primary practice location
108 Kyden Drive
Marshall, IL 62441
Mailing address
801 E Jasper LN
Newton, IL 62448-8020
Phone (618) 553-2627
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.301875 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604016000000",
"number": "1063012813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 E JASPER LN",
"city": "NEWTON",
"state": "IL",
"postal_code": "624488020",
"telephone_number": "618-553-2627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 KYDEN DRIVE",
"city": "MARSHALL",
"state": "IL",
"postal_code": "62441",
"telephone_number": "217-826-8013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "ERICA",
"middle_name": "DIANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-30",
"last_updated": "2020-10-30",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.301875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.