NPIMap

Organization Active NPI

Jennifer Weatherly, D.O., P.a.

  • Family Medicine Physician
  • Lancaster, TX
National Provider Identifier
1184909566
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L3871 Issued in TX
Legal business name
JENNIFER WEATHERLY, D.O., P.A.
Practice address
3250 W Pleasant Run Rd
160
Lancaster, TX 75146-1050
Phone
(972) 274-5200
Fax
(972) 274-5217
NPI assigned
Oct 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Authorized official

Name
Tammy Walker
Title
Office Manager
Phone
(972) 274-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X L3871 TX Primary

Addresses

Primary practice location

3250 W Pleasant Run Rd
160
Lancaster, TX 75146-1050

Mailing address

3250 W Pleasant Run Rd
160
Lancaster, TX 75146-1050
Phone (972) 274-5200

Other identifiers 1

IdentifierTypeStateIssuer
L3871OtherTXLICENSE

National Provider Directory

National Provider Directory
Tax ID family
Jennifer Weatherly DO PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1184909566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 W PLEASANT RUN RD",
            "address_2": "160",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461050",
            "telephone_number": "972-274-5200",
            "fax_number": "972-274-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W PLEASANT RUN RD",
            "address_2": "160",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461050",
            "telephone_number": "972-274-5200",
            "fax_number": "972-274-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER WEATHERLY, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "972-274-5200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L3871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "L3871",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.