Edward Leo Weist III

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00287800 Issued in NJ

Practice address

1420 S Black Horse Pike
Williamstown, NJ 08094-9130

Phone

(856) 875-0100

NPI assigned

Mar 26, 2015

Last updated

Mar 26, 2015By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1194119156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 S BLACK HORSE PIKE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949130",
            "telephone_number": "856-875-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S BLACK HORSE PIKE",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949130",
            "telephone_number": "856-875-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIST",
        "first_name": "EDWARD",
        "middle_name": "LEO",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00287800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #06174)
• Walgreens
• Vanessa Esther Wallace, MSW, LSW
• Kevin Clarke Walpole
• Sarah Aliza Weiss
• Olimpia Welsh
• Kemley Whiteside, MBA, MA
• Jennifer Williams, LCSW
• Williamstown Pediatric Practice,PA
• Brody Arthur Wilmore

• Physical Therapy Assistant in Williamstown, NJ
• Providers in Williamstown, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.