Andrew Everett Weller, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD452882 Issued in PA

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Phone

(215) 590-7555

NPI assigned

Apr 6, 2012

Last updated

Sep 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1154687804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074405",
            "telephone_number": "215-955-9823",
            "fax_number": "215-503-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "ANDREW",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD452882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellcare Pharmacy 4 LLC (Wellcare Pharmacy 4)
• Wellcare Pharmacy Inc
• Wellcare Pharmacy Inc
• Wellcare Pharmacy Inc
• Elena K Wellens, D.P.M
• Cynthia R Weller, AUDIOLOGIST
• Jamie Nicole Weller, M.D.
• Carlene Nathlee Welles
• Denva Grace Wellington, RN, BSN
• Wellmart Pharmacy Inc. (La Vida Discount Pharmacy)

• Child & Adolescent Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.