Individual provider Active NPI

Jaime Lee Weddingfeld, PHARMD

  • Pharmacist
  • Bloomington, IL
National Provider Identifier
1154924025
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.297833 Issued in IL
Practice address
1130 S Veterans Pkwy
Bloomington, IL 61704-7117
Phone
(309) 661-1839
Fax
(309) 661-8160
NPI assigned
Nov 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.297833 IL Primary

Addresses

Primary practice location

1130 S Veterans Pkwy
Bloomington, IL 61704-7117

Mailing address

1130 S Veterans Pkwy
Bloomington, IL 61704-7117
Phone (309) 661-1839

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051.297833ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1154924025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S VETERANS PKWY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047117",
            "telephone_number": "309-661-1839",
            "fax_number": "309-661-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S VETERANS PKWY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047117",
            "telephone_number": "309-661-1839",
            "fax_number": "309-661-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDDINGFELD",
        "first_name": "JAIME",
        "middle_name": "LEE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.297833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.