Weldon Medical Products Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

PED 228 Issued in FL

Legal business name

WELDON MEDICAL PRODUCTS INC.

Practice address

36 S College St
Suite 102
Macclenny, FL 32063-2439

Phone

(904) 472-5374

Fax

(904) 259-0579

NPI assigned

Jan 14, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Tyler Wayne Weldon, C-PED

Title

Owner/Operator

Phone

(904) 237-5648

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1083003040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 S COLLEGE ST",
            "address_2": "SUITE 102",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632439",
            "telephone_number": "904-472-5374",
            "fax_number": "904-259-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S COLLEGE ST",
            "address_2": "SUITE 102",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632439",
            "telephone_number": "904-472-5374",
            "fax_number": "904-259-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELDON MEDICAL PRODUCTS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "WELDON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "904-237-5648",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C-PED"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "PED 228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS- TAXONOMY CODE FOR 'PEDORTHIST'",
            "identifier": "224L00000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.