Active NPI
Shelly Denise Weise, EDD
- Physical Therapist
- San Angelo, TX
National Provider Identifier
1063632545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1089472
- Practice address
- 120 E Harris Ave
San Angelo, TX 76903-5904 - Phone
- (325) 653-6741
- NPI assigned
- Apr 26, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1089472 | TX | Primary |
| General Acute Care Hospital | 282N00000X | 1089472 | TX |
Addresses
Primary practice location
120 E Harris Ave
San Angelo, TX 76903-5904
Mailing address
2172 S. Road 3
San Angelo, TX 76905
Phone (325) 942-2581
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 |
|---|---|---|---|
| 1089472 | TX | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539820800000",
"number": "1063632545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2172 S. ROAD 3",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "76905",
"telephone_number": "325-942-2581",
"fax_number": "325-942-2548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E HARRIS AVE",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769035904",
"telephone_number": "325-653-6741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISE",
"first_name": "SHELLY",
"middle_name": "DENISE",
"name_prefix": "Dr.",
"credential": "EDD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2018-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1089472",
"primary": true
},
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "TX",
"license": "1089472",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
- Jacob Webster, PA-C
- Lani Annette Webster, LPC
- Karl K Wehner, MD
- William A Weidner
- Taylor Weiershausen, PNP
- West Loop Medical Clinic Inc
- West Texas Child Development Center
- West Texas Counseling & Guidance Inc
- West Texas Counselling and Rehabilitation Program of San Angelo, Inc. (WTCR San Angelo, Inc.)
- West Texas Dermatology and Skin Cancer Center PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.