Active NPI
Timothy R. Weichert, DO, PHD,FACOI
- Internal Medicine Physician
- Traverse City, MI
National Provider Identifier
1114986098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 5101012287
- Practice address
- 3537 W Front St Ste I
Traverse City, MI 49684-9651 - Phone
- (231) 935-8950
- Fax
- (231) 935-8868
- NPI assigned
- Mar 21, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5101012287 | MI | Primary |
Addresses
Primary practice location
3537 W Front St Ste I
Traverse City, MI 49684-9651
Mailing address
3537 W Front St Ste I
Traverse City, MI 49684-9651
Phone (231) 935-8950
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1152800585 | Other | MI | BCBSM |
| 3363234 | Medicaid | MI | |
| 110152828 | Other | RR MEDICARE |
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 Osteopathy, Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indigo Services, PLC | Internal Medicine | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AEFHAA
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1114986098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3537 W FRONT ST STE I",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496849651",
"telephone_number": "231-935-8950",
"fax_number": "231-935-8868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3537 W FRONT ST STE I",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496849651",
"telephone_number": "231-935-8950",
"fax_number": "231-935-8868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEICHERT",
"first_name": "TIMOTHY",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "DO, PHD,FACOI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-21",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5101012287",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "1152800585",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3363234",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110152828",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.