Individual provider Active NPI

Kathleen M Weckesser, R.N.

  • Registered Nurse
  • Macomb, MI
National Provider Identifier
1134364839
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704075677 Issued in MI
Practice address
48519 American Elm Dr
Macomb, MI 48044-1429
Phone
(586) 226-9974
NPI assigned
Dec 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704075677 MI Primary

Addresses

Primary practice location

48519 American Elm Dr
Macomb, MI 48044-1429

Mailing address

48519 American Elm Dr
Macomb, MI 48044-1429
Phone (586) 226-9974

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704075677MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1134364839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48519 AMERICAN ELM DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441429",
            "telephone_number": "586-226-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48519 AMERICAN ELM DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441429",
            "telephone_number": "586-226-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WECKESSER",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704075677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.