Kirk L Weller, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD17310 Issued in OR

Practice address

5050 NE Hoyt St Ste 315
Portland, OR 97213-2982

Phone

(503) 215-8580

NPI assigned

Jul 3, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kweller953965@oc.providencedirect.org

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.

• Weller Neurology LLC

  • Neurology Physician
  • Gresham, OR
  • NPI 1659891455
  NPD (past) Authorized official
• Providence Health & Services Oregon

  dba Providence Hood River Memorial Hospital

  • Clinical Pathology Physician
  • Hood River, OR
  • NPI 1053862714
  NPD
• Portland Neurology & Sleep PC

  • Sleep Specialist (PhD)
  • Portland, OR
  • NPI 1346593357
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1235169566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132982",
            "telephone_number": "503-215-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24900 SE Stark St",
            "address_2": "Suite 211",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970303355",
            "country_code": "US",
            "telephone_number": "503-699-0435",
            "fax_number": "503-618-1859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5050 NE Hoyt St Ste 615",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132958",
            "country_code": "US",
            "telephone_number": "503-215-8580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLER",
        "first_name": "KIRK",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD17310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062661",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kweller953965@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 315",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wellbeing Trailhead LLC
• Wellbridge Pain Care LLC (The WellBridge Clinic)
• Jennifer Welle
• Kristen S Wellenbrock, PSYD
• Weller Inc (Crown Optical & Safety)
• Ryan Weller, LCSW
• Samantha Weller
• Christine Wellert
• Wellify Health
• Wellington Provider Group, PC

• Neurology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Neurology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.

Verify at the official NPI Registry.