Individual provider Active NPI

Samuel Draper Weirich, M.D.

  • Orthopaedic Hand Surgery Physician
  • Vancouver, WA
National Provider Identifier
1093814642
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
MD00027264 Issued in WA
Practice address
203 SE Park Plaza Dr
Suite 140
Vancouver, WA 98684-5886
Phone
(360) 449-7039
Fax
(960) 449-7034
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X MD19018 OR
Orthopaedic Hand Surgery Physician 207XS0106X MD00027264 WA Primary

Addresses

Primary practice location

203 SE Park Plaza Dr
Suite 140
Vancouver, WA 98684-5886

Mailing address

15920 Oswego Shore CT
Lake Oswego, OR 97034-3617
Phone (503) 699-0438

Other identifiers 1

IdentifierTypeStateIssuer
061890MedicaidOR

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

LicenseStateTypeSpecialty
MD00027264WAMDOrthopaedic Hand Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093814642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15920 OSWEGO SHORE CT",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343617",
            "telephone_number": "503-699-0438",
            "fax_number": "503-699-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 SE PARK PLAZA DR",
            "address_2": "SUITE 140",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845886",
            "telephone_number": "360-449-7039",
            "fax_number": "960-449-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIRICH",
        "first_name": "SAMUEL",
        "middle_name": "DRAPER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "OR",
            "license": "MD19018",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "WA",
            "license": "MD00027264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061890",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

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.

Verify at the official NPI Registry.