Active NPI
Ryan Michael Weideman
- Pharmacist
- Middletown, OH
National Provider Identifier
1184389850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03441278
- Practice address
- 1915 Central Ave
Middletown, OH 45044-4401 - Phone
- (513) 420-2546
- NPI assigned
- Nov 7, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03441278 | OH | Primary |
| Pharmacist | 183500000X | RP456101 | PA |
Addresses
Primary practice location
1915 Central Ave
Middletown, OH 45044-4401
Mailing address
5091 Stewart Ave Apt 101
Cincinnati, OH 45227-3672
Phone (724) 996-0950
Other practice location 1
1915 Central Ave
Middletown, OH 45044-4401
Phone (513) 420-2546
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03441278 | OH | MD | Pharmacist |
| RP456101 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of Ohio Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Rite Aid Pharmacy 01260
- Community/Retail Pharmacy
- Middletown, OH
- NPI 1831105147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636243200000",
"number": "1184389850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5091 STEWART AVE APT 101",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452273672",
"telephone_number": "724-996-0950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 CENTRAL AVE",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450444401",
"telephone_number": "513-420-2546"
}
],
"practiceLocations": [
{
"address_1": "1915 Central Ave",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "OH",
"postal_code": "450444401",
"country_code": "US",
"telephone_number": "513-420-2546",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEIDEMAN",
"first_name": "RYAN",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-07",
"last_updated": "2021-11-07",
"certification_date": "2021-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03441278",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP456101",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Middletown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.