Active NPI
Sally Rose Weiss, MD
- Psychiatry Physician
- Bangor, ME
National Provider Identifier
1083787360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 10694
- Practice address
- 700 Mt Hope Ave
Suite 600
Bangor, ME 04401-5600 - Phone
- (207) 947-2591
- Fax
- (207) 947-2591
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 10694 | ME | Primary |
Addresses
Primary practice location
700 Mt Hope Ave
Suite 600
Bangor, ME 04401-5600
Mailing address
700 Mt Hope Ave
Suite 600
Bangor, ME 04401-5600
Phone (207) 947-2591
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003400 | Other | ME | ANTHEM BCBS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10694 | ME | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083787360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 MT HOPE AVE",
"address_2": "SUITE 600",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015600",
"telephone_number": "207-947-2591",
"fax_number": "207-947-2591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 MT HOPE AVE",
"address_2": "SUITE 600",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015600",
"telephone_number": "207-947-2591",
"fax_number": "207-947-2591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "SALLY",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ME",
"license": "10694",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "003400",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.