NPIMap

Organization Active NPI

Ronald Weems Jr. P.C.

  • Dentist
  • Granite City, IL
National Provider Identifier
1104098144
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019025159 Issued in IL
Legal business name
RONALD WEEMS JR. P.C.
Practice address
3429 Nameoki Rd
Granite City, IL 62040-3709
Phone
(618) 452-2006
Fax
(618) 452-3077
NPI assigned
Mar 31, 2008
Organization subpart
Yes
Parent organization
RONALD WEEMS JR. P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Authorized official

Name
Amanda Henderson
Title
Business Assistant
Phone
(618) 288-6201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019025159 IL Primary

Addresses

Primary practice location

3429 Nameoki Rd
Granite City, IL 62040-3709

Mailing address

26 Ginger Creek Pkwy
PO Box 430
Glen Carbon, IL 62034-3502
Phone (618) 288-6201

Other names 1

  • Nameoki Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ronald Weems Jr PC5 organizations share this tax ID, including this one
Part of
Ronald Weems Jr PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3429 Nameoki Rd
Granite City, IL 62040
Phone (618) 452-2006

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338249600000",
    "number": "1104098144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GINGER CREEK PKWY",
            "address_2": "PO BOX 430",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343502",
            "telephone_number": "618-288-6201",
            "fax_number": "618-288-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3429 NAMEOKI RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403709",
            "telephone_number": "618-452-2006",
            "fax_number": "618-452-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD WEEMS JR. P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RONALD WEEMS JR. P.C.",
        "enumeration_date": "2008-03-31",
        "last_updated": "2012-05-29",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS ASSISTANT",
        "authorized_official_telephone_number": "618-288-6201"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nameoki Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.